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The Incidence of Physiatry-Relevant Complications in Trauma Patients Admitted to an Urban Canadian Trauma Center

MacDonald, Shannon L., MD, MSc; Robinson, Lawrence R., MD

American Journal of Physical Medicine & Rehabilitation: February 2019 - Volume 98 - Issue 2 - p 165–168
doi: 10.1097/PHM.0000000000001021
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The objective of this study was to describe the incidence of complications in trauma patients that could be prevented, diagnosed, or managed by a consulting acute care physiatrist. Demographic and complication data were extracted by chart review of adult trauma patients admitted to a Canadian academic trauma center. Subjects were included if they had a diagnosis of traumatic brain injury, spinal cord injury, or multiple injuries resulting in an Injury Severity Score greater than 15. Means and standard deviations were calculated for continuous variables and frequencies for categorical data. Secondary analyses involved using Spearman's ρ and χ2 analysis to examine relationships between the development of complications and various patient factors. A total of 286 individuals were included. The overall incidence of a physical medicine & rehabilitation-relevant complication was 32.9%. The complications with the highest incidence were pneumonia (15.5%), delirium (14.1%), and urinary tract infection (13.4%). Secondary analyses demonstrated associations between the development of complications with older age, the presence of comorbidities, having both a traumatic brain injury and spinal cord injury, and length of stay. This study demonstrated that trauma patients may experience multiple complications that are of relevance to the consulting physiatrist.

From the Division of Physical Medicine & Rehabilitation, Department of Medicine, University of Toronto, Toronto, Ontario, Canada (SLM, LRR); and Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada (LRR).

All correspondence should be addressed to: Lawrence R. Robinson, MD, St. John's Rehab, 285 Cummer Ave, Room S125, Toronto, ON, Canada M2M 2G1.

The project was funded by the Sunnybrook Academic Health Science Centre Alternative Funding Plan Innovation Fund.

Shannon L. MacDonald is in training.

Financial disclosure statements have been obtained, and no conflicts of interest have been reported by the authors or by any individuals in control of the content of this article.

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