the development of secondary medical complications.
Limited associations were found between level, as well
as completeness, of injury and the development of com-
plications. The only significant association was found
between level of injury, tetraplegia vs paraplegia, and
prevalence of neuropathic pain, with those with tetra-
plegia being at greater risk. The literature offers little
explanation as to why those with tetraplegia are more
affected by neuropathic pain (16). Finding ways of ma-
naging neuropathic pain in acute care and rehabilitation
is a priority, since neuropathic pain is found to contribute
to reduced quality of life in patients with SCI (17). We
further found no noteworthy association between injury
characteristics and return-to-work after one year, as well
as the development of secondary complications during
acute care and rehabilitation and return-to-work.
This study presents some noteworthy limitations.
It reports only on the presence of secondary medical
complications and not the severity of the problem.
It is likely that severity may play a role in return-to-
work, for example. This study did not collect informa-
tion on quality-of-life in order to assess the effect of
complications on overall well-being. In addition, no
information of other noteworthy concomitant injuries
was collected. Taken together, this information is
required in order to advocate for the development or
implementation of interventions targeting complica-
tions impacting on quality of life. Therefore, future
studies should collect data on the severity of secondary
medical complications, concomitant injuries and qua-
lity of life more consistently, with the aim of providing
comprehensive management plans.
In conclusion, Sweden offers specialized care to
people with TSCI. However, some complications, i.e.
UTIs, pneumonia, neuropathic pain and spasticity, are
still prevalent. In order to optimize people’s recovery,
attention should be focused on reducing the occurrence
of these common complications.
ACKNOWLEDGEMENTS
The authors would like to thank all participants who took part
in this study.
Neuroförbundet provided financial support to conduct this
study. The funding agency had no role in the conception, plan-
ning and execution of this study.
The authors have no conflicts of interest to declare.
517
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