Objective

To identify the self-reported frequency of emergency department (ED) visits, ED-related hospitalizations, and reasons for ED visits among people with traumatic spinal cord injury (SCI) and compare them with general population data from the same geographic area.

Design

Cross-sectional.

Setting

A specialty hospital in the Southeastern United States.

Participants

The participants (N=648) were community-dwelling adults (18 years and older) with a traumatic SCI, who were at least 1 year postinjury. A comparison group of 9728 individuals from the general population was retrieved from the 2017 National Health Interview Survey (NHIS).

Interventions

Not applicable.

Main Outcome Measures

Participants completed self-report assessments on ED visits, ED hospitalizations, and reasons for ED visits in the past 12 months using items from the NHIS.

Results

A total of 37% of participants with SCI reported at least 1 ED visit, and 18% reported at least 1 ED hospitalization in the past 12 months. Among those having at least 1 ED visit, 49% were admitted to hospitals. After controlling for sex, age, and race/ethnicity, participants with SCI were 151% more likely to visit the ED (odds ratio [OR], 2.51) and 249% more likely to have at least 1 ED hospitalization than the NHIS sample (OR, 3.49). Persons with SCI had a higher percentage of ED visits because of severe health conditions, reported an ED was the closest provider, and were more likely to arrive by ambulance. NHIS participants were more likely to visit the ED because no other option was available.

Conclusions

Compared with those in the general population, individuals with SCI have substantially higher rates of ED visits, yet ED visits are not regularly assessed within the SCI Model Systems. ED visits may indicate the need for intervention beyond the acute condition leading directly to the ED visits and an opportunity to link individuals with resources needed to maintain function in the community.

中文翻译：

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外伤性脊髓损伤后急诊科就诊、相关住院和急诊科使用原因

客观的

确定创伤性脊髓损伤 (SCI) 患者自我报告的急诊科 (ED) 就诊频率、与急诊科相关的住院治疗以及就诊原因，并将其与同一地理区域的一般人群数据进行比较。

设计

横截面。

环境

美国东南部的一家专科医院。

参与者

参与者（N = 648）是社区居住的成年人（18 岁及以上），患有创伤性 SCI，伤后至少 1 年。从 2017 年全国健康访谈调查 (NHIS) 中检索到来自普通人群的 9728 人的对照组。

干预措施

不适用。

主要观察指标

参与者使用 NHIS 的项目完成了过去 12 个月内就诊、急诊住院和就诊原因的自我报告评估。

结果

共有 37% 的 SCI 参与者报告至少 1 次急诊就诊，18% 的参与者报告在过去 12 个月内至少有 1 次急诊住院。在至少有 1 次急诊就诊的患者中，49% 入院。在控制了性别、年龄和种族/民族后，与 NHIS 样本相比，SCI 参与者去急诊室的可能性增加了 151%（比值比 [OR]，2.51）和至少 1 次住院的可能性增加了 249%。或，3.49）。由于严重的健康状况，SCI 患者的 ED 就诊比例较高，据报道 ED 是最近的提供者，并且更有可能乘坐救护车到达。NHIS 参与者更有可能访问 ED，因为没有其他选择。

结论

与普通人群相比，SCI 患者的 ED 就诊率要高得多，但 SCI 模型系统并未定期评估 ED 就诊。急诊就诊可能表明需要在直接导致急诊就诊的急性病症之外进行干预，并有机会将个人与维持社区功能所需的资源联系起来。