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High rate of adverse events found among patients with traumatic spinal cord injuries

Issue: December 2011

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CHICAGO — More than 83% of patients who had a traumatic spinal cord injury also sustained adverse events while undergoing acute hospital care at one center, according to researchers from Canada.

The findings were presented by John Street, MD, PhD, at the 2011 Annual Meeting of the North American Spine Society .

“We all know and appreciate that traumatic spinal cord injuries are associated with incidence of adverse events and complications, but the actual rate of those complications and the implications for length of stay and overall quality of life in the long-term are unclear,” Street said.

Data collection

Street and colleagues performed a database search of patients who underwent care at Vancouver General Hospital between 2008 and 2009 for a traumatic spinal cord injury (TSCI). The team collected information about the patients’ injuries, diagnoses, hospital admission and SF-36 scores. They also prospectively collected pre-, intra- and postoperative information about adverse events for the patients.

The study included 110 patients who sustained a TSCI. Adverse event data for these patients were compared to injury characteristics, in addition to an analysis of the impact these events had on length of stay and SF-36 scores.

Adverse events

With a follow-up period that ranged from 11 months to 27 months, the team found adverse events occurred in 83.6% of patients. The investigators found that 20% of these were an intraoperative event and 79.1% were a pre- or postoperative event.

These events, Street reported, included urinary tract infections (UTI), pneumonia, neuropathic pain, pressure sores and delirium — with length of stay being “significantly impacted” by pressure sores, pneumonia, UTI and delirium.

The study’s results point to the need for a dedicated collection system for adverse events.

“We found that 77% of patients suffered at least one acute adverse event during their hospital stay,” Street said. “It’s clear that prospective monitoring with strict adherence to a rigid protocol for adverse events demonstrates a much higher incidence than previously reported. Adverse events are clearly associated with a longer acute stay, and the implication is higher cost.”

Reference:

• Cheung A, Street J, Noonan V, et al. Incidence and impact of acute adverse events in patients with traumatic spinal cord injury. Paper #3. Presented at the 2011 Annual Meeting of the North American Spine Society. Nov. 2-5. Chicago.
• Disclosure: Street has no relevant financial disclosures.

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