READMISSIONS DUE TO SECONDARY HEALTH CONDITIONS IN SPINAL CORD INJURY PATIENTS AT A PRIVATE REHABILITATION FACILITY IN SOUTH AFRICA

Mashola M.K.¹, Mothabeng D.J.¹, Olorunju S.²

¹University of Pretoria, School of Health Care Sciences, Physiotherapy, Pretoria, South Africa, ²Medical Research Council of South Africa, Pretoria, South Africa

Background: There is a dearth of literature on readmission incidences due to secondary health conditions (SHCs) as well as risk factors for specific SHCs in spinal cord injury patients in the South African context. This study will bridge the literature gap.

Purpose: This study aimed to investigate the readmission rates and the prevalence of SHCs in spinal cord injury patients.

Methods: This study was approached quantitatively using archival design. Patient files from a private rehabilitation facility in Pretoria were perused from January 2008-December 2012. Reasons and number of readmissions were coded; together with SCI profile and total length of stay (LOS) per SHC as well as outcome-based rehabilitation levels at initial discharge. Data was analyzed using STATA 12/13 and multivariate logistic regression was used to evaluate association between various factors.

Results: A total of 100 patients were readmitted and subsequently, 28 patients had a second readmission, third readmission (10 patients) and fourth readmission (2 patients). Readmissions were most commonly caused by PUs, UTIs and deteriorating neurology. Pressure ulcers accounted for 39%, 39%, 60% and 50% in the first to the fourth readmission respectively. Similarly, UTIs accounted for 12%, 25% and 40% in the first to third readmission. Deteriorating neurology accounted for 5% of the total readmissions with no subsequent readmissions. Although the LOS varied with each SHC, PUs showed disproportionate total LOS of 2173 days as compared to UTI (69 days) and deteriorating neurology (136 days).

Conclusion(s): Younger patients with complete tetraplegia are readmitted to hospital within four years after injury due to PUs and UTIs. Middle-aged and older patients with incomplete tetraplegia are readmitted during the same period due to deteriorating neurology.

Implications: Secondary health conditions are usually the precursor to readmissions and as such, SHC prevention is vital to reducing the readmission rates. Specific preventative programs will need to be implemented to reduce the medical costs incurred with readmissions due to SHCs.

Funding acknowledgements: This study was personally funded by the authors

Topic: Neurology: spinal cord injury

Ethics approval: The Faculty of Health Sciences Research Ethics Committee of the University of Pretoria granted ethical approval (number 21/2014).

All authors, affiliations and abstracts have been published as submitted.