Nontraumatic spinal cord injury: an Italian survey.
OBJECTIVE
To describe the demographic and clinical characteristics and the clinical course of patients with nontraumatic spinal cord injury (SCI).


METHODS
A multicenter prospective study.


METHODS
Thirty-two rehabilitation centers in several Italian regions.


METHODS
Patients with nontraumatic SCI (N=330) on first admission (February 1, 1997-January 31, 1999) to rehabilitation centers.


METHODS
Not applicable.


METHODS
Indicators of rehabilitation process quality were efficient bladder and bowel management. The indica-tor of neurologic recovery was improvement in American Spinal Injury Association Impairment Scale (AIS) level at discharge. The indicator of rehabilitation outcome was return home. Length of stay (LOS) was also measured as an indicator of the care process.


RESULTS
Of the 330 patients, 30% exhibited an improvement in AIS classification at discharge, and 73% returned home. In multivariate analysis, a longer LOS was associated with vascular etiology, complete lesions, residence outside the district of the rehabilitation center, and presence of clinical complications. Neurologic improvement was related to incompleteness of the lesion and longer LOS. Factors predicting a return home were married status, incompleteness of lesion, clinical improvement, efficient bowel and bladder management, absence of pressure ulcers, and longer LOS.


CONCLUSIONS
Patients showed long waiting times between diagnosis and initiation of rehabilitation, a good chance of improvement on the AIS, and low rates of home returns.
Citterio
Antonietta
A
Neuroepidemiology Unit, IRCCS C. Mondino, Pavia, Italy. antonietta.citterio@mondino.it
Franceschini
Marco
M
Spizzichino
Lorenzo
L
Reggio
Arturo
A
Rossi
Bruno
B
Stampacchia
Giulia
G
D018450:Disease Progression; D005242:Fecal Incontinence / Q000209:etiology / Q000517:prevention & control; D005260:Female; D006302:Health Services Research; D006801:Humans; D007558:Italy / Q000453:epidemiology; D007902:Length of Stay / Q000706:statistics & numerical data; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010043:Outcome and Process Assessment, Health Care; D010351:Patient Discharge / Q000706:statistics & numerical data; D003668:Pressure Ulcer / Q000209:etiology / Q000517:prevention & control; D011379:Prognosis; D011446:Prospective Studies; D019984:Quality Indicators, Health Care; D020127:Recovery of Function; D012047:Rehabilitation Centers / Q000592:standards*; D012111:Residence Characteristics / Q000706:statistics & numerical data; D012307:Risk Factors; D013119:Spinal Cord Injuries / Q000453:epidemiology / Q000209:etiology* / Q000534:rehabilitation*; D013997:Time Factors; D016896:Treatment Outcome; D014549:Urinary Incontinence / Q000209:etiology / Q000517:prevention & control