title: Effect of timing of stabilization on length of stay and medical complications following spinal cord injury.
abstract: This retrospective study examines length of acute hospital stay (LOS) and the development of medical complications in 64 patients with cervical, thoracolumbar or cauda equina injuries divided into two groups according to whether they underwent spinal stabilization < 24 hours after injury or > 24 hours after injury. The mean length of stay for the early stabilization group was 37.5 days (SD +/- 34.2) and for the late stabilization group 54.7 days (SD +/- 40.1). This difference was statistically significant by Mann Whitney U test (Z = 2.53, P = 0.01). There was no statistically significant difference between the early and the late groups with respect to the occurrence of common medical complications. There was a statistically significant difference in age in the early group (mean of 32.4 years) versus the late group (mean of 41.9 years) (t = 2.36, P = 0.02); however we do not feel that this age difference is clinically significant. There was not a statistically significant difference between the early group (17.9, SD = +/-7.2) and the late group (21.3, SD = +/- 8.3) (t = 1.71, p = 0.10) in mean injury Severity Scores (ISS). Also the correlation between length of stay and ISS scores was not significant (r = 0.18, P = 0.2). Timing of spinal stabilization appears to be an important factor in the management of spinal cord injury survivors. Our limited retrospective study suggests that when spinal stabilization is indicated, performance < 24 hours after injury is associated with a significantly shorter length of stay in the hospital. We suspect this is due to earlier mobilization of the patient. Medical complication rates were not significantly affected.
authors.affiliation: Department of Physical Medicine and Rehabilitation, UMDNJ-New Jersey Medical School, Newark 07103-2406, USA.
authors.forename: D I
authors.initials: DI
authors.lastname: Campagnolo
authors.forename: R E
authors.initials: RE
authors.lastname: Esquieres
authors.forename: K J
authors.initials: KJ
authors.lastname: Kopacz
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D009989:Orthotic Devices; D010264:Paraplegia / Q000209:etiology / Q000503:physiopathology / Q000601:surgery; D011782:Quadriplegia / Q000209:etiology / Q000503:physiopathology / Q000601:surgery; D013119:Spinal Cord Injuries / Q000150:complications* / Q000601:surgery / Q000628:therapy*; D013997:Time Factors