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Pre-Hospital and Post-Hospital Quality of Care in Traumatic Spinal Column and Cord Injuries in Iran Publisher



Zeinaddinimeymand A1 ; Baigi V1, 2 ; Mousavinasab MM3 ; Shool S1 ; Sadeghinaini M4 ; Azadmanjir Z5 ; Jazayeri SB1 ; Berchi Kankam S6 ; Dashtkoohi M7, 8 ; Shakeri A9 ; Fakharian E10 ; Kouchakinejaderamsadati L11 ; Pirnejad H12 ; Sadeghibazargani H13, 14 Show All Authors
Authors
  1. Zeinaddinimeymand A1
  2. Baigi V1, 2
  3. Mousavinasab MM3
  4. Shool S1
  5. Sadeghinaini M4
  6. Azadmanjir Z5
  7. Jazayeri SB1
  8. Berchi Kankam S6
  9. Dashtkoohi M7, 8
  10. Shakeri A9
  11. Fakharian E10
  12. Kouchakinejaderamsadati L11
  13. Pirnejad H12
  14. Sadeghibazargani H13, 14
  15. Bagheri L15
  16. Pourandish Y16
  17. Amiri M17
  18. Pourrashidi A18
  19. Harrop J19
  20. Rahimimovaghar V1, 7, 20, 21, 22
Show Affiliations
Authors Affiliations
  1. 1. Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
  2. 2. Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
  3. 3. Research Committee of Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  4. 4. Department of Neurosurgery, Lorestan University of Medical Sciences, Khorramabad, Iran
  5. 5. Department of Health Information Management, School of Allied Medical Sciences, Tehran University of Medical Sciences, Tehran, Iran
  6. 6. International Neurosurgery Group (ING), Universal Scientific Education and Research Network (USERN), Tehran, Iran
  7. 7. Brain and Spinal Cord Injury Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
  8. 8. Students’ Scientific Research Center (SSRC), Tehran University of Medical Sciences, Tehran, Iran
  9. 9. Department of Neurosurgery, Arak University of Medical Sciences, Arak, Iran
  10. 10. Trauma Research Center, Kashan University of Medical Sciences, Kashan, Iran
  11. 11. Guilan Road Trauma Research Center, Guilan University of Medical Sciences, Rasht, Iran
  12. 12. Patient Safety Research Center, Clinical Research Institute, Urmia University of Medical Sciences, Urmia, Iran
  13. 13. Research Center for Evidence Based Medicine, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
  14. 14. Road Traffic Injury Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
  15. 15. Shahid Rahnemoun Hospital, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
  16. 16. Department of Nursing, School of Nursing, Arak University of Medical Sciences, Arak, Iran
  17. 17. Department of Neurosurgery, Imam Hossein Hospital, Shahroud University of Medical Sciences, Shahroud, Iran
  18. 18. Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
  19. 19. Department of Neurological and Orthopedic Surgery, Thomas Jefferson University, Philadelphia, PA, United States
  20. 20. Department of Neurosurgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
  21. 21. Universal Scientific Education and Research Network (USERN), Tehran, Iran
  22. 22. Institute of Biochemistry and Biophysics, University of Tehran, Tehran, Iran

Source: Global Spine Journal Published:2025


Abstract

Study design: A retrospective study. Objectives: The quality of care (QoC) for spinal column/cord injury patients is a major health care concern. This study aimed to implement the QoC assessment tool (QoCAT) in the National Spinal Cord/Column Injury Registry of Iran (NSCIR-IR) to define the current state of pre- and post-hospital QoC of individuals with Traumatic Spinal Column and Spinal Cord Injuries (TSC/SCIs). Methods: The QoCAT, previously developed by our team to measure the QoC in patients with TSC/SCIs, was implemented in the NSCIR-IR. The pre-hospital QoC was evaluated through a retrospective analysis of NSCIR-IR registry data. Telephone interviews and follow-ups of patients with SCI evaluated the QoC in the post-hospital phase. Results: In the pre-hospital phase, cervical collars and immobilization were implemented in 46.4% and 48.5% of the cases, respectively. Transport time from the scene to the hospital was documented as <1 hour and <8 hours in 33.4% and 93.9% of the patients, respectively. Post-hospital indicators in patients with SCI revealed a first-year mortality rate of 12.5% (20/160), a high incidence of secondary complications, reduced access to electrical wheelchairs (4.2%) and modified cars (7.7%), and low employment rate (21.4%). Conclusion: These findings revealed a significant delay in transport time to the first care facilities, low use of immobilization equipment indicating low pre-hospital QoC. Further, the high incidence of secondary complications, low employment rate, and low access to electrical wheelchairs and modified cars indicate lower post-hospital QoC in patients with SCI. These findings imply the need for further planning to improve the QoC for patients with TSC/SCIs. © The Author(s) 2023.
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