Health-Related Quality of life in Patients with non-traumatic myelopathy at two neurology referral clinics in Addis Ababa : Facility-based cross-sectional study
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Date
2020-11
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Addis Abeba University
Abstract
Background: Non-traumatic spinal cord injury is to a range of conditions caused by infection,autoimmune, vascular, neoplastic, metastatic, and compressive lesions. The health care option topatients with spinal cord injury, usually supportive and rehabilitative, assumes to have a longtermbenefit, hence requires continuous monitoring of Quality of life as an outcome measure,with the overall goal of optimizing patient functioning and well-being. There is little information available on the quality of life in patients with non-traumatic spinalcord injury in Ethiopia. This study identifies the health-related quality of life in patients withnon-traumatic myelopathy at two neurology referral clinics Of Tikur Anbessa SpecializedHospital and & Zewditu Memorial Hospital.
Methods: Institution-based cross-sectional study was conducted among a sample of 50 patientswith non-traumatic spinal cord injury, using short-form -36 questionnaires to determine theHealth-related Quality of life. The data was collected through face-to-face and through phoneinterviews from Tikur Anbessa Specialized Hospital and Zewditu Memorial Hospital fromMarch 2019-October 2020.
Results- The mean age of the patients was 42.5±14.33. 23(46%) of them were males and27(54%) were females with a male to female ratio of 1:1.1. 45(90%) patients were parapareticand 18(36%) were bowel and bladder incontinent. The most common cause of non-traumatic myelopathy was compressive myelopathy (42%), followed by Transverse myelitis (34%). HIVmyelopathy was seen in 4(8%) patients. The mean HRQOL was 37.08±25.41. 29(58%) patientswith non-traumatic spinal cord injury fall in the lower range of HRQOL (0-33) while 12(24%)and 9(18%) in the moderate range (34-66), and higher range (67-100) respectively. The role ofphysical and role emotional domains were significantly affected. The body pain domain wasleast affected. Patients who walk supported were found to have significantly lower HRQOLcompared to those unsupported patients (OR= 0.009, 95%CI: 0.001-0.097, P-Value= 0.01).Patients with sphincter dysfunction have lower HRQOL compared to those patients with nosphincter dysfunction (OR =1.600, 95%CI: 1.223- 2.093). Unemployment was found to have asignificant association with low HRQOL (OR=0.014, 95% CI 0.004-0.0092, P-value =0.0021).
Conclusion -Patients with non-traumatic myelopathy have a low health-related quality of life.Walking with support, unemployed, and patients with sphincter dysfunction have low HRQOL. The role physical and role of the emotional domain were significantly affected so thatphysiological and emotional support should be part of the rehabilitation therapy. Governmentand non-government organization should involve NTSCI patients by forming platforms to suitemployment of this group of patients
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Keywords
Non-traumatic myelopathy,Quality of life, Patients