The burden of acute care of patients with traumatic vs. non-traumatic SCI: A comparative study.

OBJECTIVE

Spinal tumors are the leading cause of acute SCI. Little is known about the care pathway and outcomes of patients with SCI due to NESCC. This paper aims to compare the burden of care of patients with TSCI vs. SCI caused by neoplastic epidural spinal cord compression (NESCC).

DESIGN

Retrospective cohort study.

SETTING

Level-1 trauma center in Montreal, Canada.

PARTICIPANTS

of 441 consecutive patients with TSCI, or NESCC.

METHODS

Sociodemographic variables and injury characteristics were collected. The rates of pneumonia, urinary tract infection, pressure injury, and the length of stay in the acute care before discharge were compared between patients with NTSCI vs. TSCI. Multivariable analyzes were then performed to determine if the etiology of SCI was independently associated with the outcomes above.

RESULTS

Of the 441 patients recruited, 124 presented with NESCC and 317 with TSCI. Individuals with NESCC were less likely be male, were older, had more comorbidities and were more likely to present incomplete paraplegia. In addition, they had lower rates of pneumonia (8.1% vs. 19.2%; P = 0.004), UTI (10.5% vs. 20.5%; P = 0.013), and shorter average acute length of stay (21.7 ± 18.4 vs. 28.3 ± 20.2; P = 0.002), while the rates of pressure injuries were similar. At the multivariable level, a NTSCI was associated with lower odds of urinary tract infection (OR = 0.235; P = 0.013) and shorter LOS (=-0.189; P = 0.004).

CONCLUSION

Despite being older and presenting more comorbidities, patients with NESCC have lower rates of acute complications and shorter length of stays in the acute hospitalization, regardless of the severity of the initial injury.