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Spinal Cord Injury

SCI: Benefits and Risks/Harms of Implementation (2009)

Benefits and Risks or Harms of Implementing the Recommendations

Safety issues must be reviewed carefully for each adult with spinal cord injury.  General benefits and risks associated with implementation of the guideline are addressed for each recommendation.
 
When implementing these recommendations:
 
  • Review the patient’s age, socioeconomic status, cultural issues, health history, and co-morbid conditions.  An individualized assessment of each patient's home resources, including caregiver availability and meal preparation resources, is vital in this population.

     

  • Because the life adjustments associated with a catastrophic spinal cord injury are usually overwhelming to both the patient and the patient’s family, appropriate consultations with mental health and social services professionals should be considered when planning nutrition care.

Potential Benefits

A primary goal of implementing these recommendations includes improving the  nutritional status and quality of life of adults with spinal cord injury.  MNT employing a variety of nutrition interventions may result in improved nutritional intake, mobility, nutrition-related clinical parameters, weight management, and improved overall nutritional quality of life.  Additonal benefits of nutrition care provided by a Registered Dietitian may include increased ability to participate in therapies, reduction in the risk of onset and progression of nutrition-related comorbidities such as pressure ulcers, and increased ability to participate in home and community activities.  MNT can reduce complications, decrease length of stay and enhance rehabilitation outcomes.

 

Although costs of medical nutrition therapy sessions and reimbursement vary, MNT is essential for improved outcomes in patients with spinal cord injury.  MNT can be considered cost effective when weighing the benefits of appropriate nutrition therapy to prevent co-morbidities versus the cost of medical intervention. For example, MNT to ensure adequate protein and micronutrient intake may promote healthy skin integrity, thus saving the considerable costs of treatment for a developed pressure ulcer. 

Risk or Harm Considerations

When implementing nutrition care for persons with spinal cord injury, evaluate barriers that may hinder the application of nutrition recommendations.  Use clinical judgment in applying the guidelines when evaluating patients with co-morbid conditions.