Authors (including presenting author) :
Yip KH(1), Chan YL(1), Lau WLC(1), Lee YT(1), Ko WN(1), Cheng KHW(2), Li KK(2), Cheung PCL(2)
Affiliation :
(1)Department of Occupational Therapy, Kowloon Hospital (2)Department of Orthopaedics & Traumatology, Queen Elizabeth Hospital
Introduction :
Spinal cord injury (SCI) rehabilitation involves multidisciplinary approach. Occupational therapists (OT) play an important role in the rehabilitation team by facilitating regain of functioning and reintegration to community. To achieve optimal functional outcomes, management of complication is a major focus. The study aims to provide local data about complication and readmission of SCI patients to guide OT practice in SCI rehabilitation.
Objectives :
1) To identify the demographics in different neurological level of injury (NLOI) 2) To explore the post discharge one-year reasons of readmission (ROR), length of stay and number of readmission
Methodology :
A retrospective study of SCI patients admitted to Kowloon Hospital Spinal Center (KHSC) from 2011-2020 were recruited for examining their demographics. The 1-year post discharge medical records were analyzed to investigate the frequency, causes and duration of readmission. Between groups comparison was analyzed for different neurological levels of injury (NLOI), including cervical, thoracic and lumbar.
Result & Outcome :
Total of 237 SCI patients were included, with male accounted for 66% (n=154) and female accounted for 34% (n=83). Majority of them suffered from cervical NLOI (59%, n=140), followed by thoracic NLOI (22%, n=52) and lumber NLOI (19%, n=45)
83 patients (35.0%) readmitted within 1-year post discharge from KHSC. They accounted for 194 readmission episodes with 1595 bed-days in total. The average episode of readmission was 0.82 and the average length of stay was 6.73 days. There are 43 patients (18.1%) with more than 1 episode of readmission. The most common reasons of readmission were: genitourinary (37.4%), musculoskeletal (17.8%), pressure sore (11.2%), respiratory (9.34%), fall (3.73%) and other medical conditions (20.6%). There were no significant difference in number of readmission (F(3,237)=0.686, p=0.562) and length of stay (F(3,237)=1.402, p=0.243) between different NLOI. This study was comparable to the United State’s research and database.
The study guided future OT service development to proactively prevent top three SCI-related complications and readmission. Potential areas of collaboration with the clinical team include interventions for bladder program, incorporation of advanced technology to manage musculoskeletal conditions (e.g. 3D printing, exoskeleton), and utilization of pressure mapping technology.
