Abstract
Study design: To study the short- and long-term medical complications encountered in tetraplegic spinal cord injured persons (TSCI) and to give prominence to both the medical and socio-economic factors with which they are respectively associated.
Methods: The Tetrafigap Study is a multicentre epidemiological survey carried out using self-administered questionniares studying the global long-term outcome of TSCI patients after the initial phase of rehabilitation.
Results: The data for 1668 patients were analyzed. The rate of rehospitalisations was 74.4% with on average three stays per patient and as reported causes, in descending order: urinary complications, systematic follow-up, pressure sores, respiratory complications, contractures, bowel complications, pains and secondary fractures of the lower limbs. At the time of the survey, 84.7% of patients mentioned awkward contractures, 73.8% pains, 55.9% embarrassing urinary leakage and 14.1% pressure sores. With regard to persons suffering from complete motor lesion, urinary complications and pressure sores were more frequently reported, whereas for persons suffering from incomplete motor lesions, awkward contractures and pains were more frequent. In the elderly, pains were more often mentioned, and pressure sores and pain were also the most common in patients coming from lower socio-professional status. Contractures and pain decreased with time. All these complications but pressure sores and pain are statistically interrelated.
Conclusion: The medical complications of spinal cord injured persons are frequent, they are linked to biological, psychological and environmental factors, and are interrelated. Therefore, seeking mid- and long-term risk factors must be given priority in order to better adapt attempts at increasing secondary prevention.
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Acknowledgements
The TETRAFIGAP Survey was carried out thanks to grants from the following organisations which we wish to thank: HANDITEC the ‘Association de Gestion de fonds pour l'Insertion Professionnelle Des Personnes Handicapes’, (AGEFIPH), the ‘Association des Paralyses de France’ (APF) the ‘Fondation des Mutuelles Du Mans-Fondation de France, the ‘Fondation Suisse de la paraplegie’, the ‘Centre European d'analyses des Risques (CEESAR), the ‘Institut pour la Recherche sur la moelle Epiniere’, (IRME). The authors also wish to thank Papa Abdou (APF) for carrying out statistical analyses and Karine Traverse and Françoise Marchand (INSERM/RFRH) for their assistance with translation.
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The Tetrafigap survey, carried out under the aegis of the ‘Association Francophone Internationale des Groupes d'Animation de la Paraplégie’ (AFIGAP), was achieved thanks to the participation of the Tetrafigap group which involves a steering committee including D Boulongne, M Delcey, JF Desert, M Maury, JP Pedelucq, JF Ravaud and M Tramblay and the 35 associated teams mentioned below:
1 Berck-Hôpital franco-américain (Dr Allas)
2 Berck-Centre Hélio-marin (Dr Chikhi)
3 Bichat (Pr Bedoiseau)
4 Bois-Guillaume (Pr Beuret-Blanquart)
5 Bordeaux (Pr Barat, Dr Petit)
6 Bouffémont (Dr Thévenin-Lemoine)
7 Bourbon-Lancy (Drs Malier, Estéve)
8 Bruxelles (Drs Heilporn, Biefnot)
9 Cerbère (Dr Enjalbert, M. Rosebande)
10 Charleville Mézières (Drs Delrez, Skoda)
11 Club de loisirs et d'entraide de Garches
12 Coubert (Dr Désert)
13 Garches (Prs Bussel et Dizien, Dr Lortat-Jacob et Tramblay)
14 Genève-Hôpital Cantonal Universitaire, (Pr Chantraine, Dr Castagnier)
15 Giens (Drs Boucand et Tournebise)
16 Invalides (INI, Dr Dumurgier, Dr Barouti)
17 Kerpape (Drs Busnel, Cormerais, Pédelucq)
18 La Membrolle sur Choisille (Dr Chauvet)
19 L'Arche (Drs Egon, Isambert)
20 La Tour-de-Gassies (Dr N'Guyen Van Tam, Dr Wiart)
21 Lay-Saint-Christophe (Dr Grugerolle, Dr Thisse)
22 L'Hospitalet-Montoire (Dr Simon)
23 Limoges (Prs Labrusse et Dudognon, Dr Munoz)
24 Lyon-Henry Gabrielle (Pr Boisson)
25 Lyon-Henry Gabrielle (Pr Eyssette, Dr Frenay)
26 Marseille-Clinique St-Martin (Dr Chapuis-Ducoffre)
27 Marseille-Valmante (Drs Benezet et Allovon)
28 Montpellier-Propara (Dr. O'Hanna, Dr Rouays-Mabit)
29 Mulhouse (Dr Jacob-Chia)
30 Nantes (Pr Mathé, Drs Perrouin-Verbe et Rome)
31 Neufmoutiers-en-Brie-Les Lycéens (Dr François)
32 Pen-Bron (Dr Tanguy)
33 Rennes Beaulieu (Pr Brissot, Dr Gallien)
34 Saint-Hilaire du Touvet (Dr Pauget)
35 Strasbourg (Dr Pinelli)
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Klotz, R., Joseph, P., Ravaud, J. et al. The Tetrafigap Survey on the long-term outcome of tetraplegic spinal cord injured persons: Part III. Medical complications and associated factors. Spinal Cord 40, 457–467 (2002). https://doi.org/10.1038/sj.sc.3101317
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