Study about Morbidity and Mortality in Chronic Spinal Cord Injury

Mortality in patients with traumatic spinal cord injury: Descriptive analysis of 62 deceased subjects Roland Thietje 1 , M.H. Pouw 3 , A.P. Schulz 2 , B. Kienast 1 , Sven Hirschfeld 1 1 Centre for Spinal Injuries, BG Trauma Hospital Hamburg, Germany, 2 Dept. of Biomechanics and Orthopaedic Research, University Hospital Lübeck, Germany, 3 Spine Unit, Department of Orthopedic Surgery, Radboud University Nijmegen Medical Centre, NL Study design: Retrospective study. Objective: To investigate the causes of death in patients who were ≤ 50 years at the time of traumatic spinal cord injury (tSCI). Setting: Convenience sample of a tertiary rehabilitation center. Methods: All deceased patients with tSCI who survived a minimum of 10 years post-injury, were included. In addition, causes of death were compared between subjects surviving < 10 years and ≥ 10 years. Neurological assessments were performed according to the American Spinal Injury Association scale. Data on causes of death were analyzed using the ICD-10 classifications. Differences were calculated using the Mann – Whitney and chi-square tests. Results: A total of 100 patients, with 38 and 62 surviving < 10 and ≥ 10 years, respectively, were included. No significant differences in causes of death were identified between these two groups. In patients surviving ≥ 10 years, paraplegia was associated with a higher life expectancy compared with tetraplegia, 34 and 25 years ( p = 0.008), respectively, and the leading causes of death were septicemia ( n = 14), ischemic heart disease ( n = 10), neoplasms ( n = 9), cerebrovascular diseases ( n = 5), and other forms of heart diseases ( n = 5). Septicemia, influenza / pneumonia, and suicide were the leading causes of death in tetraplegics, whereas ischemic heart disease, neoplasms, and septicemia were the leading causes of death in paraplegia. Conclusion: Our monocentric study showed that in 62 deceased patients with SCI, the leading causes of death were septicemia, cardiovascular diseases, neoplasms, and cerebrovascular diseases. In addition, no significant differences were identified between causes of death among patients surviving < 10 years and ≥ 10 years post-injury. Keywords: Spinal cord injuries

24 Hour Hotline Disabled Persons Protection Commission to Report Abuse or Neglect

I guess they don't mean 24 Hours In A Row! Because you can't reach them by telephone. Seriously. I'm quite discouraged by the experiences and interactions with the Commonwealth of Massachusetts. It's disappointing. I contacted a Foundation that provides assistance to people with disabling conditions and asked about resources to help my cousin with issues. The Foundation Resource Representative explained to me that what I was describing was that my cousin was 'severely mistreated' and I should call and report it. I searched on the words, 'severely mistreated' and 'disabled' and 'Massachusetts' and found the Disabled Persons Protection Commission DPPC with a 24 Hour Hotline to Report Abuse or Neglect. There are descriptions of abuse and neglect, how to recognize, abuse and neglect, who is mandated to report, etc. After reading a lot of stuff on the web site, I tried to contact the 24 Hour Hotline to Report Abuse or Neglect. Nobody answered. Seriously. I called back. Again, nobody answered. There's no option on the web site to report online. No online chat. The regular office number suggests calling 911 in an emergency. You have to wonder about all the calls people get at 911 if everybody refers people to call 911 because they just don't answer the phone in some other office that's supposed to be doing something that appears to be important. At least it appears to be important to the people who are disabled and who are being abused or neglected.

Who Would Ever Believe a Skilled Nursing Facility Would Bill the Patient Co-Pay for Days He Was In Another Hospital and Rehab?

Oddly, we can see here an Invoice from Golden Living Oak Hill including dates when the patient was actually in Beth Israel Deaconess Jordan Hospital beginning 6 July 2015, then Reliant (Spaulding Rehabilitation) beginning 15 July 2015. I actually spoke with the billing people on the phone and they insist there's nothing wrong with the bill. They said the patient had used up all his days for the benefit period and he has to pay. Really? For days when he was elsewhere? How does that work?

Settlement Agreement between the United States of America and the Beth Israel Deaconess Medical Center

Settlement Agreement between the United States of America and the Beth Israel Deaconess Medical Center

Why Not Provide a Visual Cue to Inform People of the Patient's Needs?

It's interesting to see how many Icons are present on this Information Board in the Patient's Room at a Hospital. Also, it's surprising to notice that there is no Icon to inform the staff the patient has T-6 Complete Paraplegia and is paralyzed below his injury with altered sensations. There is absolutely no visual cue. Also, there is no Wheelchair in the room. There are no notes on the board about what people 'should know' about the patient. The staff might get the idea the patient can get up and use the restroom, or fetch a bucket to vomit, or attend to some other need by himself. If there is an emergency, staff might think a young man can fend for himself and get out of the building by emergency exits. When I was visiting this patient in the hospital, I noticed there was no sign indicating need for wheelchair and there was no wheelchair for this paralyzed patient. I tried to find out who the Case Manager was. Nobody could put me in touch with the Case Manager. So I called the Brewster Ambulance Company that transported the patient to the Hospital and asked how to get the patient's Wheelchair to him at the Hospital. The Dispatcher explained to me that the Case Manager is responsible for informing the Ambulance Company that a patient is in need of a Wheelchair and then it's transported. The fabulous dispatcher organized to fetch the wheelchair upon my call. Fabulous. I thank Brewster Ambulance and wish I had known this before because for five years the patient has had a continual problem getting any wheelchair in any hospital or rehab or nursing home. Which I find to be very strange indeed. I finally wrote a few notes on the Information Board. Never heard a reply, but I think the staff realized someone was involved in advocating for the patient, and the Case Manager arranged a very nice transfer to an appropriate Rehab facility where he got the care he needed once his health issues were under control.

Once the Wheelchair showed up, at least there was a Visual Cue present in the room with the Patient. Hopefully, at least the presence of the Wheelchair would provide some kind of information to let the staff recognize what the patient needs, although it might be more effective if the need for a Wheelchair had been included in the ICONS and any other notes and planning for in the room Information.

Model System Centers

Model System Centers

T-6 Complete Paraplegic Spinal Cord Injury with History of Altered Sensations -- Suddenly Acquires Normal Sensations in Medical Record!

WOW! Did the patient suddenly recover? Why would the NP use Homan's Sign to look for Deep Vein Thrombosis in a person known to have altered sensations? It's not like this healthcare worker does not know the patient has Spinal Cord Injury -- although it is also documented here. So why does this person use a test inappropriate for a person with altered sensations? Then note the patient does not have Normal Sensations? How does this happen?