PROBLEMS OF LONG-TERM HOSPITALIZED CERVICAL SPINAL-CORD INJURY PATIENTS IN UNIVERSITY HOSPITALS

Of the 215 cervical spinal cord injury (CSCI) patients treated in Tokai University Hospital over the last 17 years, 42 who were hospitalised for more than 90 days were selected as the subjects for this survey. They were divided into two groups: group A: patients hospitalised for 180 days or more; and group B: patients hospitalised for more than 90 but less than 180 days. The aspects surveyed were: the number of days of hospitalisation, type of injury, level of spinal cord injury, extent of spinal cord paralysis, assessment based on Frankel's classifications, whether a tracheotomy was performed or not, surgical treatment, complications, and the clinical course after discharge. The most common injury for the 13 patients in group A (average stay 281 days) was a fracture-dislocation, followed next by those with a burst fracture. The majority of the 28 patients in group B (average stay was 117 days) had a central type of spinal cord injury. Characteristics observed in group A in particular were: higher segment injuries to the cervical spinal cord, complete paralysis, respiratory complications such as pneumonia, tracheotomy, or a waiting time of at least 6 months before discharge, in cases where a transfer to a rehabilitation hospital was possible. The major problems of treating CSCI patients in university hospitals are that severe cases, which are concentrated in university hospitals, are forced to occupy private rooms for long term treatment, and there is a difficulty in transferring these patients to rehabilitation hospitals. The following measures are desirable to improve the situation: construction of facilities specialising in the treatment of spinal cord injuries, and other assertive measures to be taken at national and prefectural levels.