Estudio epidemiológico sobre la demanda de rehabilitación en pacientes hospitalizados / Epidemiological study on the demand for rehabilitation in hospitalized patients

Introducción. Los especialistas en Medicina Física y Rehabilitación (MFyR) damos asistencia a pacientes que han perdido su autonomía. Hay un porcentaje considerable de pacientes hospitalizados que adquieren una discapacidad y precisan ser asistidos por terapeutas de Rehabilitación. Hemos desarrollado el presente estudio descriptivo para analizar la demanda de rehabilitación en pacientes ingresados en nuestro hospital. Material y métodos. Se realizó un estudio observacional prospectivo, que incluyó a todos los pacientes ingresados y que fueron valorados por nuestro servicio durante los meses de febrero, marzo y abril de 2008. Resultados. El número de interconsultas realizadas por el Servicio de MFyR durante los meses de febrero-abril de 2008 (60 días laborales) ha sido de 464 para atender a 345 pacientes. La media de interconsultas diaria a nuestro servicio ha sido de 7,73 y el número medio de interconsultas por paciente ha sido de 1,36 (desviación estándar [DE] 0,70; rango 1-7). De los 354 pacientes valorados durante el estudio, 55 no fueron incluidos en terapia por no cumplir los criterios, lo que significa que un 84 % de los pacientes hospitalizados ha precisado tratamiento rehabilitador. Conclusión. El presente estudio nos ha permitido conocer que un porcentaje considerable de pacientes hospitalizados necesita valoración y tratamiento por parte de los servicios de MFyR. Los servicios de Traumatología y Medicina Interna son los que demandan más nuestra asistencia. Solo un grupo minoritario de pacientes precisa continuar tratamiento de forma ambulatoria (AU)

Introduction. Specialists in Physical Medicine and Rehabilitation (FM&R) attend to patients who have lost their autonomy. A large number of hospitalized patients who had acquired a disability need to be attended by rehabilitation therapists. We have developed this descriptive study to analyze demand for rehabilitation in patients admitted to our hospital. Materials and methods. A prospective observational study was performed for all the patients admitted during the months of February, March and April 2008 who were evaluated by our department. Results. In our FM&R Department from February to April 2008 (60 days), there were 464 consultations made by 345 patients. Average daily consultations to our department was 7.73 and average number of consultations per patient was 1.36 (SD 0.70, range 1-7). Of the 354 patients evaluated during the study, 55 were not included in therapy as they did not meet the criteria. Thus 84 % of the hospitalized patients has required rehabilitation. Conclusion. This study has revealed that a considerable number of inpatients need assessment and treatment from FM&R Department. Traumatology and Internal Medicine Departments are those who demand our care the most. Only a minority of patients required outpatient physical therapy treatment (AU)

Long-term follow-up study of intraurethral stents in spinal cord injured patients with detrusor-sphincter dyssynergia.

STUDY DESIGN: Retrospective study. OBJECTIVES: To assess in the long-term clinical and urodynamic results of intraurethral stents in a group of patients with spinal cord injury. SETTING: Spinal Cord Injury Unit, Juan Canalejo Hospital, A Coruña, Spain. METHODS: Forty-seven consecutive male patients were studied from 1993 to 2002. All of them suffered from hyperreflexia with detrusor-sphincter dyssynergia (DSD) owing to spinal cord injury, and were treated by means of the placement of an intraurethral stent at the external sphincter. RESULTS: After surgery, significant decreases in all the parameters studied were observed. The number of patients with symptoms of urinary tract infection decreased by 25% (P<0.031). Post-void residual urine volume experienced an average decrease of 224.3 cm(3) (P=0.001). Episodes of dysreflexia decreased from 35.1 to 16.2% (P=0.039). The urodynamic study showed an average reduction of 44.36 cm H(2)O in the maximum detrusor pressure (P<0.0001). Complications in the upper urinary tract descended from 46.8 to 23.4% after placing the stent (P=0.013). The most frequent stent complication was displacement, followed by stenosis, lithiasis and intraprosthetic calcification. In all, 8.5% required the stent removal. CONCLUSIONS: Intraurethral stent is a good choice for the long-term management of DSD in spinal cord-injured patients, even in those who had been previously submitted to prior sphincterotomy. It has the advantage of being a potentially reversible procedure, so patients prefer it to more invasive therapies such as sphincterotomy.