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Journal of the Korean Academy of Rehabilitation Medicine 1991;15(1):12-21.
Complications in spinal cord injured patients.
Na, Young Moo , Park, Chang Il , Chun, Saeil , Shin, Jung Soon
Department of Rehabilitation Medicine, Yonsei University College of Medicine
외상성 척수손상 환자의 합병증에 관한 연구
나영무, 박창일, 전세일, 신정순
연세대학교 의과대학 재활의학교실
Abstract

The complications of spinal cord injury which develop in varying sites can lead to death and can impede rehabilitation as well as adversely affect the activities of daily living physically, socially and economically.

The purpose of this study is to look for means to prevent and manage complications in spinal cord injury through investigation and analysis.

The subjects of this study were 133 spinal cord injured patients who were admitted to the Department of Rehabilitation Medicine, Severance Hospital, Yonsei University, between Mar 1, 1983 and Dec 30, 1989.

The results are as follows;

The subjects were 111 male and 22 female patients ranging in age from 4 to 70 years, including 18 complete quadriplegics, 15 incomplete quadriplegics, 71 complete paraplegics, and 29 incomplete paraplegics. The incidence of complications in spinal cord injury were as follows; urinary tract infection 78.2%, spasticity 54.1%, pain 51.8%, pressure sore 45.1%, contracture 33.8%, orthostatic hypotension 27.8%, autonomic hyperreflexia 15.0%, heterotopic ossification 9.0%, atelectasis 5.3%, vesicoureteral reflux 5.3%, epididymitis 4.5%, urinary stone 3.0%. The most common causative organism of urinary tract infection was Escherichia coli (38.3%), followed by Enterococcus faecalis (24.6%). The most common pressure sore site was the sacral area (66.1%) and most sores were mild grade 1 to 2. The development of sores during admission in the Rehabilitation Medicine Department was much lower than other departments. The incidence of orthostatic hypotension in patients with injury at or above T5 spinal cord level was higher than at T6 or below. The incidence of autonomic hyperreflexia in patients with injury at or above T6 spinal cord level was higher than at T7 or below. Contractures developed most frequently in the ankle joint. Contracture development during admission in the department of Rehabilitation Medicine was much lower than that of other departments. Below normal values of hemoglobin, hematocrit occuring at one, three, six and twelve months post injury were 83.0%, 74.0%, 59.5% and 34.6% for hemoglobin and 72.3%, 46.0%, 38.1% and 19.2% for hematocrit respectively. Pain developed within 12 months after injury in most cases and the difference in pain incidence between males and females was not statistically significant.

Key Words: Spinal cord injury, Complications, Incidence


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