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KMID : 0388320230300020271
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Journal of Korean Academy of Fundamental Nursing
2023 Volume.30 No. 2 p.271 ~ p.280
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Time-related Complications in Patients with Traumatic Spinal Cord Injury According to the AIS Impairment Scale Grade : A Retrospective Review
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Kim Jeoung-Hee
Shin Yong-Soon
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Abstract
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Purpose: The aim of this study was to analyze time-dependent complications in patients with traumatic spinal cordinjury (SCI) as a function of their initial neurological status determined by the ASIA Impairment Scale (AIS) grade.
Methods: Consecutive patients with SCI who visited the emergency department at Asan Medical Center from 2005to 2019 were included, and their electronic medical records were analyzed according to four time periods frominitial visit to hospital discharge. Time-dependent SCI-related complications, including medical, urinary,musculoskeletal, and neurological complications and pain, were analyzed as well as the association between SCIcomplications and AIS grade. In-hospital recovery from neurological damage and long-term outcomes were alsoevaluated.
Results: Of the 632 SCI patients who visited the emergency department during the study period, 110patients were included in the study. The complication rates in patients initially assessed as AIS grades A, B, C,D, and E were 53.6%, 16.4%, 14.6%, 13.6%, and 1.8%, respectively. The most common complications after SCIwere UTIs (n=37; 33.6%), pressure ulcers (n=36; 32.7%), neuropathic pain (n=34; 30.9%), and pneumonia (n=33;30.0%). Patients with a poor neurological status (AIS grade A) had more medical complications and lowerneurological resilience than did those with better neurological status (AIS grades B-E).
Conclusion: Post-SCIcomplications differed by time after SCI and neurological status. Nurses should be aware that complications canoccur at any time in patients with traumatic SCI. Patients with poorer AIS grades should be particularly closelyobserved and receive preventive care for complications.
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KEYWORD
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Complications, Nursing, Spinal Cord Injuries
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