Nontraumatic spinal cord injury: demographic characteristics and complications

OBJECTIVES: To investigate the demographic characteristics and complications of nontraumatic spinal cord injury (NT/SCI), to compare patients who were admitted for initial rehabilitation with readmission rehabilitation patients, to compare our findings with those of other studies, and to develop a model to predict the length of stay (LOS). DESIGN: Retrospective, 3-year, case series. SETTING: Tertiary medical unit specializing in SCI rehabilitation in Australia. PARTICIPANTS: Consecutive sample of 134 adult referred inpatients with NT/SCI (58% women; median age, 61y). Patients requiring initial rehabilitation or readmission were included. INTERVENTION: Chart review. Main Outcomes Measures: Demographic characteristics, neurologic injury, etiology, comorbidities, and complications of NT/SCI. RESULTS: The most common cause of NT/SCI was tumor (20.1%), but there were many different etiologies. Tetraplegia occurred in 32.8% of patients, and 56% had motor incomplete injuries. Most patients (63%) had at least 1 complication, including urinary tract infection (32.8%), pressure ulcer (31.5%), and pain (18.7%). Initial rehabilitation patients were significantly older (initial median, 69y vs readmission median, 54y; P=.0001). A multivariate model for LOS was able to predict 52% of the variance. CONCLUSIONS: NT/SCI rehabilitation patients have a different demographic profile compared with traumatic SCI (T/SCI) patients and a lower prevalence of many of the complications that affect T/SCI patients. There are differences between initial and readmission patients.