| 1. |
- Aesoy, M. S., et al.
(författare)
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Epidemiology of persistent iatrogenic spinal cord injuries in Western Norway
- 2016
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Ingår i: Brain and Behavior. - : Wiley. - 2162-3279. ; 6:10
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: Iatrogenic spinal cord injuries (SCIs) caused by invasive procedures or surgical interventions have previously been reported as case studies. The primary objective of this study was to investigate and analyze the incidence, etiology, and prognosis of iatrogenic SCI in Western Norway. Methods: Medical records of all 183 patients admitted to the SCU between 01.01.2004 and 31.12.2013 were reviewed. Gender, age, diagnosis, iatrogenic medical procedure, symptoms and findings before and after injury, mechanism of injury, level of injury, and ASIA Impairment Scale (AIS) score prior iatrogenic SCI, at admittance and discharge were recorded, as were the length of the period prior to admittance and the length of stay. Results: Twenty-three (12.5%; 14 men, nine women) of 183 patients met the criteria for iatrogenic SCI. The annual incidence rate was estimated 2,3 per 1,000,000 (SD +/-1.0). Mean age at iatrogenic SCI was 55.5 years (range 16-79 years). Intervention for cervical spinal stenosis was the leading cause of iatrogenic SCI, followed by operations on the aorta and spine. Iatrogenic SCIs was most frequently located on the thoracic level. The patients suffered from clinical incomplete injuries (AIS score C and D) both at admittance and discharge from the SCU. Most patients improved, but no patient recovered completely after SCI. Conclusion: Although the annual incidence rate of iatrogenic SCI is low in Norway, individual consequences are serious. Increased awareness of the causes of SCI may decrease the risk of iatrogenic SCI.
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| 2. |
- Bakketun, T., et al.
(författare)
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Myelomeningocele: Need for long-time complex follow-up - An observational study
- 2019
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Ingår i: Scoliosis and Spinal Disorders. - : Springer Science and Business Media LLC. - 2397-1789. ; 14:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: Myelomeningocele (MMC) is a congenital disorder that causes a variety of acute as well as late complications. Numerous health problems in adulthood have been described by the persons with MMC but not studied in clinical setting. This study gives implications for organization of the follow-up in adulthood. Objectives: To investigate the need for follow-up from different medical specialists as well as the need for organized focused rehabilitation among adults with MMC. Methods: Retrospective cohort study on adults with MMC including multiple departments in a university hospital in Norway. The number and cause of specialized hospital consultations were recorded for every patient. Correlation between childhood health condition related to MMC and the need for specialized consultations in adulthood as well as correlations between number of consultations and anatomical level of MMC, age, and observation time was performed for the whole group. Results: In total, 38 patients had 672 consultations related to MMC. The most frequent departments were neurology, neurosurgery, urology, gastroenterology, and orthopedics. Most consultations were planned. Complexity of MMC-related health condition correlated to number of specialist consultations (rho = 0.420, p = 0.009). Anatomical level of MMC, age, and length of observation time did not correlate with consultations. Pain and shunt failure were the most common reasons for consultations. Conclusions: Persons with MMC have a need for continuous, life-long multispecialized follow-up and rehabilitation. This is crucial for optimal function, satisfaction with life, and for long-term survival. Systematic follow-up together with rehabilitation will optimize health service. © 2019 The Author(s).
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| 3. |
- Gedde, M. H., et al.
(författare)
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Traumatic vs non-traumatic spinal cord injury: A comparison of primary rehabilitation outcomes and complications during hospitalization
- 2019
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Ingår i: Journal of Spinal Cord Medicine. - : Informa UK Limited. - 1079-0268 .- 2045-7723. ; 42:6, s. 695-701
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To compare outcome for patients with traumatic (TSCI) and non-traumatic spinal cord injuries (NTSCI) after primary rehabilitation regarding neurological improvement measured by the American Spinal Injury Association Impairment Scale (AIS), length of stay and complications. Design: Retrospective comparative cohort study on patients with TSCI and NTSCI, hospitalized during a ten-year period at Haukeland University Hospital, Norway. Impairment, length of stay and complications during first in-patient rehabilitation period were analyzed. Uni- and multivariate analysis was performed. Setting: Spinal Cord Rehabilitation Unit, Haukeland University Hospital, Norway Participants: A total of 174 persons with a spinal cord injury (SCI) were included; 102 with TSCI and 72 with NTSCI. Outcome measures: Neurological improvement measured by AIS from admission to discharge, number of weeks in the hospital, frequency and significance of complications were compared. Results: Improvement in AIS after primary rehabilitation did not differ between TSCI and NTSCI. Length of stay was in average 3.4 weeks longer for TSCI. Urinary tract infections and pressure ulcers significantly influenced length of stay in both groups. Urinary tract infections were more frequent in TSCI (67%) vs NTSCI (42%). Pressure ulcers were more frequent among NTSCI (24%) vs TSCI (14%). Pneumonia and neuropathic pain did not depend on etiology and did not influence length of stay. Conclusions: Patients with SCI have a rehabilitation potential regardless of etiology. Complications are frequent in both groups and often prolong hospitalization. Complication patterns differ in the two groups, and specific prevention and optimal treatment will shorten and optimize the length of primary rehabilitation. © 2019, © The Academy of Spinal Cord Injury Professionals, Inc. 2019.
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| 4. |
- Halvorsen, A., et al.
(författare)
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Epidemiology of traumatic spinal cord injury in Norway in 2012-2016: a registry-based cross-sectional study
- 2019
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Ingår i: Spinal Cord. - : Springer Science and Business Media LLC. - 1362-4393 .- 1476-5624. ; 57:4, s. 331-338
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Tidskriftsartikel (refereegranskat)abstract
- Study design A registry-based cross-sectional study. Objectives To analyse the epidemiological and demographic characteristics of persons with traumatic spinal cord injury (TSCI) in Norway. Setting TSCI patients admitted for primary rehabilitation to one of the three specialised spinal cord injury (SCI) departments (located in Bergen, Trondheim, and Oslo) and consented to the Norwegian Spinal Cord Injury Registry (NorSCIR). Methods Analysis of data from NorSCIR during a 5-year period (2012-2016) was performed. Data were collected by using the International SCI Core Data Set as recommended by the International Spinal Cord Society (ISCoS). Results The lowest incidence of TSCI was 11.4/million (2012), and the highest incidence was 15.9/million (2014). In the study period, 349 individuals were registered with TSCI. In total, 76% were male, and the mean age was 47 (SD +/- 19) years. We observed dominance in the 60-74 years age group. The distribution between tetraplegia and paraplegia was 48%/42%. For those initially classified as American Spinal Cord Injury Association Impairment Scale (AIS) grade A (complete injury), 77% remained grade A at discharge. Considerable changes during primary rehabilitation after incomplete lesions were observed. Most patients (68%) were discharged home after primary rehabilitation. Falls were the main cause of TSCI (47%) and occurred more often during the weekend. Conclusion Through a National Medical Quality Registry based on internationally provided data sets, we are able to present systematic and updated data from Norway.
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| 5. |
- Halvorsen, A., et al.
(författare)
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Non-traumatic spinal cord injury in Norway 2012-2016: analysis from a national registry and comparison with traumatic spinal cord injury
- 2019
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Ingår i: Spinal Cord. - : Springer Science and Business Media LLC. - 1362-4393 .- 1476-5624. ; 57:4, s. 324-330
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Tidskriftsartikel (refereegranskat)abstract
- Study design Registry-based cross-sectional study. Objectives To describe and analyze epidemiological and demographic characteristics of non-traumatic spinal cord injury (NTSCI) and to compare persons with NTSCI and traumatic spinal cord injury (TSCI). Setting A total of 225 non-traumatic and 349 traumatic SCI patients were admitted for primary rehabilitation at one of the three specialized SCI departments in Norway (located in Bergen, Trondheim, and Oslo) from 2012 to 2016. Patients who consented to registration in the Norwegian Spinal Cord Injury Registry (NorSCIR) were included. Methods Data were collected using the International SCI Core Data Set, as recommended by the International Spinal Cord Society (ISCoS). Demographics and injury characteristics were analyzed descriptively. The NTSCI and TSCI groups were compared using a Mann-Whitney U test and chi-square test. Results The mean age of the NTSCI patients was 55 years, and 59% were male. The incidence of NTSCI was 7.7-10.4 per million person-years, which is lower than the incidence of TSCI. NTSCI individuals were older, less severely injured, and their length of stay at the hospital was shorter than the TSCI individuals. The results may be influenced by the inclusion criterion in the registry. This makes the analyzed sample for NTSCI less complete. However, the majority of patients with non-progressive NTSCI are included in the NorSCIR. Conclusion For the first time, we are able to provide the national epidemiological status on NTSCI based on available data from the national registry. Further studies are required to improve the capture of NTSCI for future incidence studies.
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| 6. |
- Halvorsen, Annette, et al.
(författare)
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Realizing the potentials of a National Spinal Cord Injury Registry – 10 years of experiences
- 2023
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Ingår i: Norsk Epidemiologi. - 0803-2491. ; 31:1-2, s. 49-54
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Tidskriftsartikel (refereegranskat)abstract
- The Norwegian Spinal Cord Injury Registry is a national quality registry that just celebrated its 10-year anniversary. The registry contributes to quality improvement in spinal cord injury care in Norway and other Nordic countries. The continuous improvement in clinical practice goes hand-in-hand with the further registry development. Data from the registry are furthermore used in different kinds of research projects. This article aims to provide an overview of how the Norwegian Spinal Cord Injury Registry was established, to share our experiences, insights, lessons learned during its development and ten years in operation, and to highlight its potential.
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| 7. |
- Irgens, Ingebjorg, et al.
(författare)
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Cost-utility analysis and impact on the environment of videoconference in pressure injury. A randomized controlled trial in individuals with spinal cord injury
- 2024
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Ingår i: SPINAL CORD SERIES AND CASES. - 2058-6124. ; 10:1
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Tidskriftsartikel (refereegranskat)abstract
- Study designA prospective randomized controlled trial (RCT) in persons with spinal cord injury (SCI) and ongoing pressure injury (PI).ObjectivesThe main aim was to perform a cost-utility analysis (CUA) alongside the RCT comparing regular care to regular care with additional videoconference consultations. Secondary aims were to assess costs and greenhouse gas emission related to transportation in the two study groups.SettingTwo spinal cord units in Norway.MethodsParticipants were allocated to a regular care group (RCG) and a regular care group with additional videoconference (VCG), in a 1-year follow-up between 2016 and 2018. Costs were prospectively collected, and health-related quality of life (HRQoL) data were collected at baseline and 12 months. The outcome was quality-adjusted life years (QALYs), derived from the EQ-5D-5L questionnaire. Results are reported as incremental cost-effectiveness ratio (ICER), expressed as the cost per additional QALY gained. Transportation related costs and environmental emissions were compared by t-tests.ResultsThere were 56 participants included, 28 in each group. Of these 27 in the VCG and 26 in the RCG completed. Three participants died. The mean cost per patient was euro 8819 in the VCG and euro 3607 in the RCG, with 0.1 QALYs gained in the VCG. No significant differences were identified regarding HRQoL or secondary outcomes.ConclusionThe VCG costs euro 5212 more for an additional 0.1 QALYs, giving an ICER of euro 52,120 per QALY. No significant differences were found regarding transportation-related costs, or emission of greenhouse gases.
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| 8. |
- Irgens, I., et al.
(författare)
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Hospital based care at home: study protocol for a mixed epidemiological and randomized controlled trial
- 2019
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Ingår i: Trials. - : Springer Science and Business Media LLC. - 1745-6215. ; 20
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundIndividuals with spinal cord injuries (SCI) are prone to pressure ulcers (PUs) because of the loss of sensorimotor function involved as well as increased skin moisture. Treatment of PU after SCI is complicated, involving different specialties and with need for long-lasting follow-up. This study should identify risk factors for PU after SCI, and find an effective and less time-consuming treatment for the condition among different available methods for follow-up.Method/designThe first part of this research project aims to investigate the prevalence of PU among persons with SCI based on an epidemiological design. The study will identify possible risk factors for acquiring PU. A questionnaire focusing on previous and present PUs will be sent to persons who suffered SCIs between January 2004 and January 2014. In the second part we will compare two different treatment regimens of PU through a randomized controlled pilot trial (RCT) where we will compare outpatient SCI follow-up in a hospital versus outpatient follow-up from the patient's home, using telemedicine (teleSCI) interventions. We will compare the healing of the PU in the two groups (usual care versus teleSCI). The Tissue, Infection, Moisture Edge (TIME) registration form, the Photographic Wound Assessment Tool (PWAT) and the change in the ulcer size will be used to monitor the healing. Changes in health-related quality of life (HRQoL) and the need for assistance will be assessed using the Five Dimensions European Quality of Life scale (EQ-5D), the generic Medical Outcomes Study 12-item Short Form Health Survey (SF-12) modified version, the International Spinal Cord Injury Quality of Life Data set (ISCI-QoL Data set), and the Spinal Cord Independence Measure scale, version III (SCIM III). In addition to primary outcome measures, a cost-benefit evaluation and an assessment of patient satisfaction and participation will be performed, using customized questionnaires.DiscussionThe first part of the research project will reveal the epidemiology of PU after SCI, and explore the risk factors. This part enables further prevention of PU after SCI and this information will be used in the follow-up RCT. Videoconferencing in the outpatient follow-up of persons with SCI and PU will change clinical routines and facilitate interdisciplinary collaboration, communication and competence exchange among participants of the health care services. Our research protocol allows comparing methods for interaction between medical specialists at hospitals, local caregivers in the community, next of kin, and persons with SCI and PU. The RCT should identify advantages as well as challenges in the management of PU in different follow-up settings. This study aims to identify risk factors for PU after SCI, and find an effective and less time consuming treatment for the condition among different available methods for follow- up.Trial registration list list-type="order www.ClinicalTrials.gov, ID: NCT02800915, last update 9 October 2017.The National Regional Ethical Committee (REC) 2014/ 684/ REK-Nord. https://helseforskning.etikkom.no/prosjekterirek/prosjektregister/prosje kt?p_document_id=469163&p_parent_id=473640&_ikbLanguageCode=nhttps://app .cristin.no/projects/show.jsf?id=545284https://www.sunnaas.no/kliniske-s tudier/bruk-av-telemedisin-som-virkemiddel-til-samhandling-i-poliklinisk -oppfolging-av-pasienter-med-ryggmargsskade-og-trykksar
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| 9. |
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| 10. |
- Irgens, I., et al.
(författare)
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Spinal cord injury and development of pressure injury during acute rehabilitation in Norway: a national retrospective cross-sectional study
- 2020
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Ingår i: Spinal Cord. - : Springer Science and Business Media LLC. - 1362-4393 .- 1476-5624. ; 58, s. 1069-1079
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Tidskriftsartikel (refereegranskat)abstract
- Study design A national, retrospective, cross-sectional study. Objectives To analyze the prevalence of pressure injury (PI), and characteristics associated with PI development in the hospitalized population of persons with a newly acquired spinal cord injury (SCI) between 2004 and 2014. Setting All three specialized Spinal Cord Units in Norway. Methods Demographic data related to prevalence and potential risk factors were retrieved from the electronic medical record (EMR). Statistical analyses were performed, using IBM SPSS Statistics, version 23. Results We identified 1012 individuals with a new SCI. Mean age at injury was 48 years (SD 19). The period prevalence of PI was 16% (95% CI = 0.14-0.19), and identified PI associations were complete SCI (OR = 0.1), being injured abroad (OR = 2.4), bowel (OR = 13), and bladder (OR = 9.2) dysfunction; comorbidities like diabetes mellitus 1 (OR = 7.9), diagnosed depression (OR = 3.8), ventilator support (OR = 3.0), drug abuse (OR = 3.0), and concurrent traumatic brain injury (OR = 1.7). Individuals in the age group of 15-29 years had higher odds of PI compared with middle-aged individuals (45-59 years). Conclusion PI is a serious complication after SCI. The association between depression or comorbidity and PI occurrence should be investigated more thoroughly. We recommend implementation of a simple follow-up program regarding observation and prevention of PI. Increased awareness of factors that could contribute to PI will help to focus on better prevention and early recognition of PI. This will contribute to more optimal rehabilitation.
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