Early Predictors of Rehabilitation Outcomes After Acute Traumatic SCI
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The existence of integrated trauma systems and trauma registries has proved to be essential in improving trauma-related survival rates, with an overall reduction in risk of death of up to 25% when care was provided at a trauma center. The reduction in mortality is attributed to improved and effective triage in the field and highly specialized regional trauma centers that can provide skilled care in a timely manner.
Delivering care for an individual based on mortality statistics is critical for patients’ survival, but to improve the delivery of care for those that survive, data points beyond mortality are required. The relationships between assessments and management protocols initiated at the scene, in the emergency department (ED) and acute care hospital with functional outcomes during rehabilitation needs to be known to further improve patient care. Currently separate data bases exist within emergency medical services (EMS), Trauma and Rehabilitation, but they don’t talk to each other. The merger of information from these databases will provide the information that may alter current decision based management protocols based on functional outcomes rather than mortality.
Our aims for this study are:
1) What data elements from the scene of an accident, emergency department and acute care hospital are associated with functional outcomes?
2) What is the nature of that association for persons from different sub-groups?
3) What is the impact of pre-hospital hypoxemia, hypotension, and transport-time on neurological function?
4) What is the impact of acute hospital MRI characteristics and MAP <85 on neurological function?