Incidência de Disreflexia Autonómica num Serviço de Medicina Física e de Reabilitação

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.