Incidence of Autonomic Dysreflexia in the Physical Medicine and Rehabilitation Inpatients

Authors

  • Cristina Miranda Cruz Médica interna de Medicina Física e Reabilitação no Hospital de Braga
  • Marta Oliveira Médica interna de Medicina Física e Reabilitação no Hospital de Braga
  • Maria Berkeley Cotter Médica interna de Medicina Física e Reabilitação no Hospital de Braga
  • Ivone Soares Médica assistente hospitalar, Serviço de Medicina Física e Reabilitação, Hospital de Braga
  • Fátima Martins Ferreira Médica assistente hospitalar graduada, Serviço de Medicina Física e Reabilitação, Hospital de Braga

DOI:

https://doi.org/10.25759/spmfr.266

Keywords:

Autonomic Dysreflexia/epidemiology, Dysreflexia/etiology, Inpatients, Spinal Cord Injuries/ complications, Spinal Cord Injuries/rehabilitation

Abstract

Introduction: Our objective was to ascertain the incidence of autonomic dysreflexia in spinal cord injury inpatients during the hospitalization; to identify the main triggering factors; to determine which variables influence the incidence of autonomic dysreflexia.

Methods: A retrospective review of patients with spinal cord injury was conducted. This study scoped all patients with an injury level above T6 admitted to a physical medicine and rehabilitation department from January 2011 to December 2013. The following data were collected from the medical records: autonomic dysreflexia episodes, demographic information, patient’s characteristics, triggering factors and need of pharmacological treatment. The Statistical Package for the Social Sciences (SPSS) was used to analyze the data.

Results: A percentage of 12.7% of the included patients developed autonomic dysreflexia; 71.4% autonomic dysreflexia episodes occurred in patients with complete spinal cord injuries (AIS A). All autonomic dysreflexia episodes occurred in patients with traumatic spinal cord injury and with cervical spinal cord injury levels. The main triggers of autonomic dysreflexia were genitourinary (48%) and gastrointestinal (44.2%). Oral antihypertensive medication was administered in 26.5% of events.

Conclusion: Autonomic dysreflexia is an uncommon complication in spinal cord injury patients. It is important to be aware of this condition, since the effective treatment requires early diagnosis, reversal of trigger factors and, if needed, the prompt administration of pharmacological treatment.

Downloads

Download data is not yet available.

References

Braddom R L, Rocco J F. Autonomic dysreflexia: a survey of current treatment. Am J Phys Med Rehabil. 1991;70:234-41.

Khastgir J, Drake M, Abrams P. Recognition and effective management of autonomic dysreflexia in spinal cord injuries. Expert Opin Pharmacother. 2007;8:945-56.

Krassioukov A, Warburton D E, Teasell R. A systematic review of the management of autonomic dysreflexia after spinal cord injury. Arch Phys Med Rehabil. 2009;90:682-95.

Furusawa K, Tokuhiro A, Sugiyama H, Ikeda A, Tajima F, Genda E, et al. Incidence of symptomatic autonomic dysreflexia varies according to the bowel and bladder management techniques in patients with spinal cord

injury. Spinal Cord. 2011;49:49-54.

Brown R, Burton A, Macefield VG. Input-output relationships of a somatosympathetic reflex in human spinal injury. Clin Auton Res. 2009;19:213-20.

Strine AC, Mellon MJ. Autonomic dysreflexia: evaluation and management. Curr Bladder Dysfunct Rep.2013;8:319-25.

Bycroft J, Shergill IS, Chung EA, Arya N, Shah PJ. Autonomic Dysreflexia: a medical emergency. Postgrad Med J. 2004;81:232-5.

Jackson CR, Acland R. Knowledge of autonomic dysreflexia in the emergency department. Emerg Med J. 2011;28:866-9.

Te AE. A modern rationale for the use of phenoxybenzamine in urinary tract disorders and other conditions. Clin Ther. 2002;24:851-60.

Branco F, Cardenas D, Svircev J. Spinal cord injury: a comprehensive review. Phys Med Rehabil Clin N Am. 2007;18:651-79.

Furlan JC. Autonomic dysreflexia: a clinical emergency. J Trauma Acute Care Surg. 2013;75:496-500.

Lindan R, Leffler EJ, Kedia KR. A comparison of the efficacy of an alpha i-adrenergic blocker in the slow calcium channel blocker in the control of autonomic dysreflexia. Paraplegia. 1985;23:34-8.

Lindan R, Joiner E, Freehafer A, Hazel C. Incidence and clinical features of autonomic dysreflexia in patients with spinal cord injury. Paraplegia. 1980;18:285-92.

Silver JR. Early autonomic dysreflexia. Spinal Cord. 2000; 38: 229-233.

Krassioukov A, Furlan J, Fehlings MG. Autonomic dysreflexia in acute spinal cord injury: an under-recognized clinical entity. J Neurotrauma. 2003;20:707-16.

Schottler J, Vogel L, Chafetz R, Mulcahey M J. Patient and caregiver knowledge of autonomic dysreflexia among youth with spinal cord injury. Spinal Cord; 2009;47: 681-6.

How to Cite

1.
Miranda Cruz C, Oliveira M, Berkeley Cotter M, Soares I, Martins Ferreira F. Incidence of Autonomic Dysreflexia in the Physical Medicine and Rehabilitation Inpatients. SPMFR [Internet]. 2017 Dec. 23 [cited 2024 Nov. 24];29(2):23-9. Available from: https://spmfrjournal.org/index.php/spmfr/article/view/266

Issue

Section

Original Article

Similar Articles

<< < 12 13 14 15 16 17 18 19 20 > >> 

You may also start an advanced similarity search for this article.