Quality of in-hospital care in traumatic spinal column and cord injuries (TSC/SCI) in I.R Iran.

Autor: Sadeghi-Naini M; Department of Neurosurgery, Lorestan University of Medical Sciences, Khoram-Abad, Iran., Jazayeri SB; Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran., Kankam SB; Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran.; International Neurosurgery Group (ING), Universal Scientific Education and Research Network (Usern), Tehran, Iran., Ghodsi Z; Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran.; Brain and Spinal Cord Injury Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran., Baigi V; Department of Neurosurgery, Lorestan University of Medical Sciences, Khoram-Abad, Iran., Zeinaddini Meymand A; Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran., Pourrashidi A; Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran., Azadmanjir Z; Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran.; Brain and Spinal Cord Injury Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran., Dashtkoohi M; Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran.; School of Medicine, Tehran University of Medical Sciences, Tehran, Iran., Zendehdel K; Cancer Institute of Iran, Tehran University of Medical Sciences, Tehran, Iran., Pirnejad H; Patient Safety Research Center, Clinical Research Institute, Urmia University of Medical Sciences, Urmia, Iran.; Erasmus School of Health Policy and Management (ESHPM), Erasmus University Rotterdam, Rotterdam, The Netherlands., Fakharian E; Trauma Research Center, Kashan University of Medical Sciences, Kashan, IR, Iran., O'Reilly GM; School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.; Emergency and Trauma Centre, The Alfred, Melbourne, Australia.; National Trauma Research Institute, The Alfred, Melbourne, Australia., Vaccaro AR; Department of Orthopedics and Neurosurgery, Rothman Institute, Thomas Jefferson University, Philadelphia, PA, USA., Shakeri A; Neurosurgical Surgery Department, Arak University of Medical Sciences, Arak, Iran., Yousefzadeh-Chabok S; Guilan Road Trauma Research Center, Guilan University of Medical Sciences, Rasht, Iran., Babaei M; Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran.; School of Medicine, Tehran University of Medical Sciences, Tehran, Iran., Kouchakinejad-Eramsadati L; Guilan Road Trauma Research Center, Guilan University of Medical Sciences, Rasht, Iran., Haji Ghadery A; Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran.; Department of Radiology, Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Tehran, Iran., Aryannejad A; Experimental Medicine Research Center, Tehran University of Medical Sciences, Tehran, Iran., Piri SM; Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran., Azarhomayoun A; Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran., Sadeghi-Bazargani H; Road Traffic Injury Research Center, Tabriz University of Medical Sciences, Tabriz, Iran., Daliri S; Clinical Research Development Unit, Imam Hossein Hospital, Shahroud University of Medical Sciences, Shahroud, Iran., Lotfi MS; The University of Social Welfare and Rehabilitation Sciences, Tehran, Iran., Pourandish Y; Department of Nursing, School of Nursing, Arak University of Medical Sciences, Arak, Iran., Bagheri L; Shahid Rahnemoun Hospital, Shahid Sadoughi University of Medical Sciences, Yazd, Iran., Rahimi-Movaghar V; Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran. v_rahimi@yahoo.com.; Brain and Spinal Cord Injury Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran. v_rahimi@yahoo.com.; Department of Neurosurgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran. v_rahimi@yahoo.com.; Universal Scientific Education and Research Network (USERN), Tehran, Iran. v_rahimi@yahoo.com.; Institute of Biochemistry and Biophysics, University of Tehran, Tehran, Iran. v_rahimi@yahoo.com.
Jazyk: angličtina
Zdroj: European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society [Eur Spine J] 2024 Apr; Vol. 33 (4), pp. 1585-1596. Date of Electronic Publication: 2023 Nov 24.
DOI: 10.1007/s00586-023-08010-x
Abstrakt: Purpose: This study aimed to implement the Quality of Care (QoC) Assessment Tool from the National Spinal Cord/Column Injury Registry of Iran (NSCIR-IR) to map the current state of in-hospital QoC of individuals with Traumatic Spinal Column and Cord Injuries (TSCCI).
Methods: The QoC Assessment Tool, developed from a scoping review of the literature, was implemented in NSCIR-IR. We collected the required data from two primary sources. Questions regarding health system structures and care processes were completed by the registrar nurse reviewing the hospital records. Questions regarding patient outcomes were gathered through patient interviews.
Results: We registered 2812 patients with TSCCI over six years from eight referral hospitals in NSCIR-IR. The median length of stay in the general hospital and intensive care unit was four and five days, respectively. During hospitalization 4.2% of patients developed pressure ulcers, 83.5% of patients reported satisfactory pain control and none had symptomatic urinary tract infections. 100%, 80%, and 90% of SCI registration centers had 24/7 access to CT scans, MRI scans, and operating rooms, respectively. Only 18.8% of patients who needed surgery underwent a surgical operation in the first 24 h after admission. In-hospital mortality rate for patients with SCI was 19.3%.
Conclusion: Our study showed that the current in-hospital care of our patients with TSCCI is acceptable in terms of pain control, structure and length of stay and poor regarding in-hospital mortality rate and timeliness. We must continue to work on lowering rates of pressure sores, as well as delays in decompression surgery and fatalities.
(© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)
Databáze: MEDLINE
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