Article

Objectives and Retrospective study : To examine the rehabilitation
outcomes for patients with spinal cord injury (SCI) due to tumour, with a focus
on the impact of pain on disability and length of stay (LOS). SETTING: Public
hospital inpatient spinal rehabilitation unit, Melbourne, Australia. METHODS:
Retrospective open-cohort case series of consecutive patients admitted between
1/7/1996 and 30/6/2008 with a diagnosis of recent onset tumour causing SCI.
RESULTS: In all 108 patients were admitted, of whom 62% (n=67) were male. The
median age was 61.5 years (interquartile range (IQR) 53.6-74). Most patients had
paraplegia (n=97, 89.8%) and a metastatic tumour (n=71, 65.7%) causing their SCI.
For patients with a primary tumour the Rasch motor functional independence
measure (FIM) gain between admission and discharge (median 17, IQR 4-23) was
significantly greater (P=0.006) than for those with secondary tumour (median 7,
IQR from -4 to 15). Pain was present in 52% of patients and had a significant
adverse influence on the rehabilitation process, with FIM motor efficiencies of
0.09 in patients with documented pain compared with 0.39 in patients without pain
(P=0.01). Patients with pain had significantly prolonged median LOS of 56 days
(IQR 32.5-84.5) compared with 42 days (IQR 20.5-72.5, P=0.03) without pain.
CONCLUSION: Patients with SCI due to tumour have the potential to benefit from a
focused, specialised SCI rehabilitation programme to optimise their outcomes.
Careful patient selection, modifying the focus of team goals and a close
relationship with treating oncologists and palliative care teams is essential.

Langue : ANGLAIS