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Rehabilitation Practice and Science

Translated Title

花蓮地區脊髓損傷之調查及防治對策

Abstract

In order to survey the epidemiological characteristics and the overall rehabilitation profile of traumatic spinal cord injuries (SCI) in Hualien county, a retrospective study was conducted from January 1987 to December 1990 in four local general hospitals. During this period, 88 traumatic SCI patients were identified. The estimated annual incidence of traumatic SCI in Hualien county was 62.3 per million population. As a result of injury 32 patients were tetraparetic, 29 were tetraplegic, 12 were paraparetic and 15 were paraplegic. The male/female ratio was 3.6:1 The mean age of onset for male patients was 44 ± 16 years, and that for female patients was 45 ± 23 years. The major causes of SCI were traffic accident (60.2%), followed by accidentally fall (23.9%). The average duration of hospitalization ranged from 67 ± 26 days in paraparetics to 135 ± 72 days in tetraplegics. The most common complications were neurogenic bladder (88%), followed by pressure sore (22%). Ten patients died of respiratory failure or sepsis, and the mortality rate was 11.4%.In the 78 patients who survived during this study, only 48 of them (62%) had received complete rehabilitation. Therefore, only 43 (55%) patients were ambulatory and 39 (55%) patients were independent in ADL. In addition, only 42 (59%) patients could attain self-voiding; the others failed to become catheter free. In summary, our data revealed that Hualien county was a prevalent area of traumatic SCI in comparison with other studies. The major reason might be attributed to the preponderance of motorcycle as a transportation vehicle. In addition, our study also found that the rehabilitation attendance rate was relatively low in SCI patients. Therefore, we propose five strategies to enhance trauma prevention as well as patient management in this region: (1) implement the traffic regulations and popularize the concept of traffic safety, (2) execute the safety precautions of working place (3) manage the alcoholism properly, (4) integrate the medical resources and establish the emergency transfer system, (5) set up a SCI center for comprehensive medico-social management of the patients.

Language

Traditional Chinese

First Page

33

Last Page

38

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