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

Of the 215 cervical spinal cord injury (CSCI) patients treated in Toka i 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, exten t of spinal cord paralysis, assessment based on Frankel's classificati ons, whether a tracheotomy was performed or not, surgical treatment, c omplications, and the clinical course after discharge. The most common injury for the 13 patients in group A (average stay 281 days) was a f racture-dislocation, followed next by those with a burst fracture. The majority of the 28 patients in group B (average stay was 117 days) ha d a central type of spinal cord injury. Characteristics observed in gr oup A in particular were: higher segment injuries to the cervical spin al cord, complete paralysis, respiratory complications such as pneumon ia, tracheotomy, or a waiting time of at least 6 months before dischar ge, in cases where a transfer to a rehabilitation hospital was possibl e. The major problems of treating CSCI patients in university hospital s are that severe cases, which are concentrated in university hospital s, are forced to occupy private rooms for long term treatment, and the re is a difficulty in transferring these patients to rehabilitation ho spitals. The following measures are desirable to improve the situation : construction of facilities specialising in the treatment of spinal c ord injuries, and other assertive measures to be taken at national and prefectural levels.