The survival status of People with Spinal Cord Afflictions following discharge from a Gauteng Provincial Government Hospital
| Autor: | Burger, Elizabeth Margaretha |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2017 |
| Druh dokumentu: | Diplomová práce |
| Popis: | A dissertation submitted to the Faculty of Health Sciences, University of the Witwatersrand, Johannesburg in fulfilment of the requirements for the degree of Master of Science (Medicine) Johannesburg November 2017. Background: A spinal cord affliction is defined as an insult to the spinal cord, and encompasses both traumatic and non-traumatic disruption to the spinal cord. There is a dearth of information on the epidemiology of spinal cord afflictions in low- and middle-income countries (LMIC) or the survival status of these individuals following discharge from hospitals. This study was conducted to determine the survival status of patients with spinal cord afflictions following discharge from a South African public sector academic hospital. Study design: This was a cross-sectional study, consisting of a five-year retrospective record review for the period 1 January 2008 until 31 December 2012, and follow up of surviving patients at their homes. Objectives: The objectives of the study were to: describe the demographic profile of People with Spinal Cord Afflictions (PSCA) discharged from the Dr George Mukhari Hospital Academic (DGMAH) Spinal Unit; determine the medical background information of all PSCA discharged; describe the environmental conditions faced by PSCA after discharge; and determine the survival status of PSCA following discharge from hospital. Setting: A public sector academic hospital, the DGMAH, in the Gauteng Province of South Africa. Methods: Using a cross-sectional study design, a record review was conducted of all PSCA admitted and treated at the DGMAH spinal unit for the period 1 January 2008 until 31 December 2012. A structured, pre-tested questionnaire was used to obtain demographic, medical and environmental information of PSCA. The patients admitted during the study period and known to be alive were contacted. During a home visit, a semi-structured questionnaire was completed with PSCAs. Descriptive data analysis was done using Microsoft Excel and Statistica ® 13. Results: A total of 264 records were reviewed and 55/264 (20.8%) of patients passed away during hospital stay. The mean age of all patients discharged during the review period was 37, standard deviation (SD) 15.3. The majority of patients discharged were male (66.3 %). In terms of medical profile, 45 % (94) had a TSCA and 48.3% (101) a NTSCA, with 6.7% (14) v unknown. The leading cause of TSCA was road traffic accidents (RTAs) at 63.7%, while tuberculosis (TB) was the leading cause for NTSCA at 43.3%. An additional 19 patients are known to have died following discharge from hospital. There was very high non-response rate of 57.8 % (n: 152) and only 19 patients were visited in their homes Conclusion: Patients with TSCAs were on average 10 years younger than those with NTSCAs. The study found that RTAs and TB were the leading causes of TSCAs and NTSCAs respectively, suggesting the need for a broader public health approach with prevention at its core. The high non-response rate suggests the need for improved hospital information systems to monitor patient outcomes after discharge. Key words: Spinal cord affliction, non-traumatic, traumatic, demographic, medical, environmental. LG2018 |
| Databáze: | Networked Digital Library of Theses & Dissertations |
| Externí odkaz: |
|