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Unplanned hospital admissions due to secondary health conditions after spinal cord injury: a population-based description of determinants of length of stay

Spinal Cord volume 61, pages 290–295 (2023)Cite this article

Subjects

Abstract

Study design

Population-based prospective study.

Objectives

To provide a population-based description of length of stay (LOS) and person-related risk factors following unplanned hospital admission due to a secondary health condition (SHC) in persons with spinal cord injury (SCI).

Setting

Specialized SCI hospital and rehabilitation center in Switzerland.

Methods

Descriptive analysis of LOS using routine clinical data of persons with SCI, who were acutely hospitalized between 01.01.2017–30.06.2018. Multivariable regression analysis was used to derive marginal predictions of LOS by acute SHCs and person characteristics.

Results

The study included 183 persons, 83% were male, and the median age was 57 years (interquartile range, IQR, 49–67 years). SCI cause was traumatic in 160 (88.4%) cases, 92 (50.3%) were persons with tetraplegia, 147 (80.3%) were classified as motor complete lesions (American Spinal Injury Association Impairment Scale (AIS) A or B) and median time since injury (TSI) was 24 (IQR 13–34) years. Median LOS was 19 (IQR 9–39) days, varying from 74 (IQR 39–92) days for pressure ulcers, 13 (IQR 8–24) days for urinary tract infections (UTI), to 27 (IQR 18–47) days for fractures. LOS was prolonged in persons with multiple co-morbidities or those developing complications during hospitalization. Sex, SCI etiology and lesion level were not associated with LOS.

Conclusions

This population-based description identified substantial variation in LOS between acute SHCs and clinical complications as the main, potentially modifiable, person-related risk factors for extended hospital stay.

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Fig. 1: Length of stay (LOS) in relation to cause of admission.

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Data availability

Additional data are available from the corresponding author on reasonable request.

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Author information

Authors and Affiliations

  1. Swiss Paraplegic Centre, Nottwil, Switzerland

    Anna M. Jedrusik, Lorena L. Müller, Susanna B. Meier, Jürgen Pannek & Inge E. Eriks-Hoogland

  2. Swiss Paraplegic Research, Nottwil, Switzerland

    Martin W. G. Brinkhof, Lorena L. Müller, Jürgen Pannek & Inge E. Eriks-Hoogland

  3. Department of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland

    Martin W. G. Brinkhof, Jürgen Pannek & Inge E. Eriks-Hoogland

  4. Department of Urology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland

    Jürgen Pannek

Authors
  1. Anna M. Jedrusik
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  2. Martin W. G. Brinkhof
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  4. Susanna B. Meier
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  6. Inge E. Eriks-Hoogland
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Contributions

AJ and SM proposed the study, and AJ, LM, and IEH accomplished its design, conceptualization and implementation. Study data were collected by AJ and SM. Statistical analysis was performed by LM and MB. AJ, LM, MB and IEH examined and interpreted the data. The manuscript was drafted by AJ, with support of LM, MB, and IEH. All authors provided critical feedback on the manuscript regarding important intellectual content, and provided their approval on the final version.

Corresponding author

Correspondence to Inge E. Eriks-Hoogland.

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Competing interests

The authors declare no competing interests.

Ethical approval

The study was formally approved by regional medical ethics committee of northwest and central Switzerland (Project-ID 2020-01629). All the participants included in the study consented to anonymized use of data for research purposes and had the option to opt out.

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Jedrusik, A.M., Brinkhof, M.W.G., Müller, L.L. et al. Unplanned hospital admissions due to secondary health conditions after spinal cord injury: a population-based description of determinants of length of stay. Spinal Cord 61, 290–295 (2023). https://doi.org/10.1038/s41393-023-00880-8

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