An audit of current practice and management of metastatic spinal cord compression at a regional cancer centre.
Affiliation
Waterford Regional Hospital, Dunmore Road, Waterford. slsui@yahoo.comIssue Date
2012-02-01T10:52:46ZMeSH
AgedFemale
Humans
Male
Spinal Cord Compression/diagnosis/*etiology/therapy
Spinal Neoplasms/*complications/*secondary
Metadata
Show full item recordCitation
Ir Med J. 2011 Apr;104(4):111-4.Journal
Irish medical journalPubMed ID
21675093Abstract
Metastatic spinal cord compression (MSCC) is an oncological emergency requiring prompt recognition and management to preserve neurological function and mobility. We performed an audit to assess current practice of MSCC against current best practice as outlined by NICE. Our retrospective audit identified 10 patients from January to December 2009 with confirmed MSCC. The most common primary tumours were prostate 3 (30%), breast 3 (30%) and lung 2 (20%). Pain was the main presenting symptom 9 (90%), followed by weakness 7 (70%) and sensory changes 1 (10%). 5 (50%) had MRI within 24 hours and only 6 (60%) underwent full MRI scan. 8 (80%) had corticosteroids before MRI scan. 6 (60%) received radiotherapy within 24 hours. Only 4 (40%) were referred to orthopaedics and none of these patients had been recommended surgery. Up 14 days following radiological confirmation of MSCC, the number of patients who were unable to walk increased by 20%. Only 5 (50%) were discharged during this period of study. Our audit reported a number of variances in management compared to NICE guideline. These can be improved by following a'fast track' referral pathway and regular education for junior doctors and primary care doctors.Language
engISSN
0332-3102 (Print)0332-3102 (Linking)
Collections
Related articles
- Malignant spinal cord compression: NICE guidance, improvements and challenges.
- Authors: Savage P, Sharkey R, Kua T, Schofield L, Richardson D, Panchmatia N, Papanastasopoulos P, Williams M, Falconer A, Power D, Arnold F, Ulbricht C
- Issue date: 2014 Apr
- Early diagnosis and treatment is crucial for neurological recovery after surgery for metastatic spinal cord compression in prostate cancer.
- Authors: Crnalic S, Hildingsson C, Bergh A, Widmark A, Svensson O, Löfvenberg R
- Issue date: 2013 May
- A population-based study of spinal metastatic disease in South-East Norway.
- Authors: Zaikova O, Giercksky KE, Fosså SD, Kvaløy S, Johannesen TB, Skjeldal S
- Issue date: 2009 Dec
- Prognostic factors for local control and survival after radiotherapy of metastatic spinal cord compression.
- Authors: Rades D, Fehlauer F, Schulte R, Veninga T, Stalpers LJ, Basic H, Bajrovic A, Hoskin PJ, Tribius S, Wildfang I, Rudat V, Engenhart-Cabilic R, Karstens JH, Alberti W, Dunst J, Schild SE
- Issue date: 2006 Jul 20
- Prognosis in patients with symptomatic metastatic spinal cord compression: survival in different cancer diagnosis in a cohort of 2321 patients.
- Authors: Morgen SS, Lund-Andersen C, Larsen CF, Engelholm SA, Dahl B
- Issue date: 2013 Jul 15