Neighborhood Deprivation is Associated With Hospital Length of Stay, Discharge Disposition, and Readmission Rates for Patients Who Survive Hospitalization With Traumatic Brain Injury.

Background And Objectives: Traumatic brain injury (TBI) is a leading cause of disability in the United States. Limited research exists on the influence of area-level socioeconomic status and outcomes after TBI. This study investigated the correlation between the Area Deprivation Index (ADI) and (1) 90-day hospital readmission rates, (2) facility discharge, and (3) prolonged (≥5 days) hospital length of stay (LOS).

Impact of preoperative mental health diagnosis on postoperative opioid use patterns in spine fusion surgery: A systematic literature review.

Opioids are frequently prescribed for patients undergoing procedures such as spinal fusion surgery for the management of chronic back pain. However, the association between a preoperative mental health illness, such as depression or anxiety, and opioid use patterns after spinal fusion surgery remain unclear. Therefore, we performed a systematic literature review in accordance with PRISMA guidelines to identify articles from the PubMed Database that analyzed the relationship between preoperative mental health illness and postoperative opioid usage after spinal fusion surgery on June 1, 2023.

Residential Mobility and Reasons for Moving Among People Living With Spinal Cord Injury: Results of a Multisite Survey Study.

Background: Residential mobility after spinal cord injury (SCI) has not been extensively examined despite a growing interest in investigating the relationship between neighborhood exposures and community living outcomes.

Objectives: This study explores residential mobility patterns, the annual move rate, and reasons for moving among a community-living sample of adults with SCI.

Methods: A survey was conducted with 690 people at six SCI Model Systems centers in the United States between July 2017 and October 2020.

Outcomes After the Surgical Evacuation of Traumatic Acute Subdural Hematomas: The tASDH Risk Score.

Background: Acute subdural hematoma (ASDH) is a common pathology following traumatic brain injury (TBI). There is sparse data on the prediction of clinical outcomes following traumatic ASDH (tASDH) evacuation. We investigated prognosticators of outcome following evacuation of tASDHs, with subset analysis in a cohort of octogenarians.

In their own words: recovery after emergency general surgery in the older patient.

Objectives: Emergency general surgery (EGS) conditions, such as perforated intestines or complicated hernias, can lead to significant postoperative morbidity and mortality. We sought to understand the recovery experience of older patients at least 1 year after EGS to identify key factors for a successful long-term recovery.

Methods: We conducted semi-structured interviews to explore recovery experiences of patients and their caregivers after admission for an EGS procedure.

Medical, dental, and optical care utilization among community-living people with spinal cord injury in the United States.

Context/objective: Information about patterns of healthcare utilization for people living with spinal cord injury (SCI) is currently limited, and this is needed to understand independent community living after SCI. This study investigates self-reported healthcare utilization among community-living people with SCI and assesses disparities across demographic, socioeconomic, and injury-related subgroups.

Design: Secondary analysis of cross-sectional survey data administered via telephone interview.

Impact of Lavender on Pain and Anxiety Levels Associated With Spine Procedures.

To reduce pain and anxiety associated with interventional pain procedures, sedation is often used, with benzodiazepines, opioids, and propofol the most commonly used classes of drugs for sedation. However, patient coherence and ability to communicate procedural pain and abnormal sensations help prevent adverse outcomes. Therefore, discovering alternative therapies to mitigate the anxiety and pain associated with these procedures and to minimize risk is important.

Trauma Indicators in Spinal Cord Injury Rehabilitation Outcomes: A Retrospective Cohort Analysis of the National Trauma Data Bank and National Spinal Cord Injury Database.

Objective: To investigate whether initial emergency department physiological measures and metrics of trauma severity predict functional outcomes and neurologic recovery in traumatic spinal cord injury.

Design: Retrospective analysis of a clinical database.

Setting: Merged multicenter data from the Spinal Cord Injury Model Systems (SCIMS) database and National Trauma Data Bank from 6 academic medical centers across the United States.

Changes in Internet Use Over Time Among Individuals with Traumatic Spinal Cord Injury.

Objective: To investigate the changes in total internet and mobile internet use over time and determine how demographic characteristics are related to changes in internet and mobile internet use among individuals with spinal cord injury (SCI).

Design: Cross-sectional analysis of a multicenter cohort study.

Setting: National SCI Database.

Who Moves After SCI? Individual, Health, and Neighborhood Predictors of Residential Mobility Among Participants in the National Spinal Cord Injury Model Systems Database.

Objective: To investigate residential mobility among community-living adults with spinal cord injury (SCI) and the individual, health, and neighborhood factors associated with the propensity to relocate.

Design: Retrospective analysis of data from the National SCI Model Systems (SCIMS) Database collected between 2006 and 2018 and linked with the American Community Survey 5-year estimates.

Setting: Community.

Blood Alcohol Concentration Is Associated With Improved AIS Motor Score After Spinal Cord Injury.

Objective: To investigate the relationship between blood alcohol concentration (BAC) and neurologic recovery after traumatic spinal cord injury (TSCI) using standardized outcome measures from the International Standards for the Neurological Classification of Spinal Cord Injury (ISNCSCI) examination.

Method: This is a retrospective review of merged, prospectively collected, multicenter data from the Spinal Cord Injury Model Systems Database and institutional trauma databases from five academic medical centers across the United States. Patients with SCI and a documented BAC were analyzed for American Spinal Injury Association Impairment Scale (AIS) motor score, FIM, sensory light touch score, and sensory proprioception score upon admission and discharge from rehabilitation.

Linking Individual Data From the Spinal Cord Injury Model Systems Center and Local Trauma Registry: Development and Validation of Probabilistic Matching Algorithm.

Background: Linking records from the National Spinal Cord Injury Model Systems (SCIMS) database to the National Trauma Data Bank (NTDB) provides a unique opportunity to study early variables in predicting long-term outcomes after traumatic spinal cord injury (SCI). The public use data sets of SCIMS and NTDB are stripped of protected health information, including dates and zip code.

Objectives: To develop and validate a probabilistic algorithm linking data from an SCIMS center and its affiliated trauma registry.

Can the electrically stimulated manual muscle test differentiate upper from lower motor neuron injury in persons with acute SCI?

Objective: To determine if the motor response on the stimulated manual muscle test (SMMT) in muscles with a grade 0 motor score on the manual muscle test (MMT) can differentiate lower motor neuron (LMN) from upper motor neuron (UMN) injury based on the presence of spontaneous activity (SA) with needle EMG.

Design: Prospective Study.

Participants/methods: Twenty-one subjects with acute traumatic cervical SCI.

Opportunities, Pitfalls, and Alternatives in Adapting Electronic Health Records for Health Services Research.

Electronic health records (EHRs) offer the potential to study large numbers of patients but are designed for clinical practice, not research. Despite the increasing availability of EHR data, their use in research comes with its own set of challenges. In this article, we describe some important considerations and potential solutions for commonly encountered problems when working with large-scale, EHR-derived data for health services and community-relevant health research.

Demonstration of pressure reduction in a new proof of concept spine board.

Pressure injuries are a significant problem following spinal cord injury (SCI). High interface pressures while lying on a spine board during emergency transport appear to play a major role in their formation. The aim of the present study was to assess the interface pressures and sensing area between the body and the standard spine board (SSB) and a proof of concept spine board prototype (-5).

Surgical and Nonsurgical Treatment of Penetrating Spinal Cord Injury: Analysis of Long-term Neurological and Functional Outcomes.

To describe long-term neurological and functional outcomes for patients with penetrating spinal cord injury (PSCI) following surgical (SX) and nonsurgical (NSX) treatment. We identified all patients with PSCI in the Spinal Cord Injury Model Systems database from 1994-2015. Patients with PSCI were divided into surgical (SX) and nonsurgical (NSX) groups.

Regionalization of Spine Trauma Care in an Urban Trauma System in the United States: Decreased Time to Surgery and Hospital Length of Stay.

Background: The effect of regionalized trauma care (RT) on hospital-based outcomes for traumatic spine injury (TSI) in the United States is unknown.

Objective: To test the hypothesis that RT would be associated with earlier time to surgery and decreased length of stay (LOS).

Methods: TSI patients >14 yr were identified using International Classification of Diseases Ninth Revision Clinical Modification diagnostic codes.

Craniectomy and Craniotomy in Traumatic Brain Injury: A Propensity-Matched Analysis of Long-Term Functional and Quality of Life Outcomes.

Objective: To report the comprehensive long-term functional and quality of life outcomes after craniectomy (CE) and craniotomy (CO) in individuals with traumatic brain injury (TBI).

Methods: Information on all individuals with TBI who had undergone CE or CO were extracted from the TBI Model Systems database from 2002 to 2012. A 1:1 propensity matching with replacement technique was used to balance the baseline characteristics across groups.

Comparing Blunt and Penetrating Trauma in Spinal Cord Injury: Analysis of Long-Term Functional and Neurological Outcomes.

Comparisons between patients with penetrating spinal cord injury (PSCI) and blunt spinal cord injury (BSCI) are scarce. To describe baseline characteristics and neurological and functional outcomes for patients with BSCI and PSCI. Participants with BSCI ( = 5,316) and PSCI ( = 1,062) were extracted from the Spinal Cord Injury Model Systems database from January 1994 to January 2015.

Operative Versus Nonoperative Management of Civilian Gunshot Wounds to the Spinal Cord: Novel Use of the Functional Independence Measure for Validated Outcomes.

Background: Surgery for patients with gunshot wound spinal cord injury (GSCI) remains controversial. Few recent studies provide standardized follow-up and detailed functional outcomes. To our knowledge, the research we present in this study is unique in that we are the first to incorporate Functional Independence Measure (FIM) scores as an outcomes measure for neurologic recovery in patients with GSCI.

Patient portals and broadband internet inequality.

Background: Patient portals have shown potential for increasing health care quality and efficiency. Internet access and other factors influencing patient portal use could worsen health disparities.

Methods: Observational study of adults with 1 or more visits to the outpatient clinics of an urban public health care system from 2012 to 2015.

What Patients With Severe Mental Illness Transitioning From Hospital to Community Have to Say About Care and Shared Decision-Making.

Shared decision-making (SDM) has been slow to disseminate in mental health. We conducted focus groups with ten individuals with serious mental illness (SMI) treated in a 90 day, outpatient transitional care clinic. Parallel groups were held with family caregivers (n = 8).

Redesign of a spine board: Proof of concept evaluation.

Sacral pressure ulcers are a significant problem in individuals following spinal cord injury (SCI) and are felt to be in part due to the high interface-pressures applied to the body while lying on a standard spine board (SSB) during emergency transport. The aim of the present study was to assess the interface pressures and sensing areas between the body and the SSB and two proof of concept spine board prototypes (P-1 and P-2). Ten able-bodied individuals were assessed on each board.

Early Predictors of Functional Outcome After Trauma.

Background: Despite the availability of routinely collected trauma data, researchers who investigate rehabilitation outcomes, functional evaluation, and comparative effectiveness have not incorporated this potentially clinically meaningful information in their modeling as predictors or adjustors.

Objective: The purpose of this study was to identify variables from the scene of a traumatic accident and from the emergency department that can be used in assessing functional outcomes of persons who survive trauma.

Design: Prospective study.