Authors: M. Cristina Pagliacci, MD M. Grazia Celani, MD Lorenzo Spizzichino, PhD Mauro Zampolini, MD Marco Franceschini, MD on behalf of the “Gruppo Italiano Studio Epidemiologico Mielolesioni” (G.I.S.E.M.) group* Affiliations: From Unita ` Spinale Unipolare, Azienda Ospedaliera di Perugia, Perugia, Italy (MCP); Servizio per le Malattie Neurologiche e Cerebrovascolari, ASL 2 Umbria, Perugia, Italy (MGC); Dipartimento della Prevenzione, Ministero della Sanita `, Roma, Italy (LS); Dipartimento di Riabilitazione, ASL 3 Umbria, Foligno, Italy (MZ); and Servizio di Riabilitazione Funzionale, Ospedale di Baggiovara, Modena, Italy (MF). Correspondence: All correspondence and requests for reprints should be addressed to M. Cristina Pagliacci, Unita ` Spinale Unipolare Ospedale Silvestrini, Azienda Ospedaliera di Perugia, 06156 Perugia, Italy. Disclosures: Supported in part by a grant from the “Fondazione M. Taramelli per la ricerca sulla mielolesione” attributed to the 3 rd author for statistical organization and analysis, and by Regional Health Administration Area public funds. *See Appendix for group members. 0894-9115/08/8708-0619/0 American Journal of Physical Medicine & Rehabilitation Copyright © 2007 by Lippincott Williams & Wilkins DOI: 10.1097/PHM.0b013e31815e8145 Hospital Care of Postacute Spinal Cord Lesion Patients in Italy Analysis of Readmissions into the GISEM Study ABSTRACT Pagliacci MC, Celani MG, Spizzichino L, Zampolini M, Franceschini M, Gruppo Italiano Studio Epidemiologico Mielolesioni: Hospital care of postacute spinal cord lesion patients in Italy: analysis of readmissions into the GISEM study. Am J Phys Med Rehabil 2008;87:619 – 626. Objectives: To define the clinical characteristics of hospital readmis- sions of subjects with spinal cord lesion. Design: Prospective, multicenter, 2-yr survey in 32 spinal cord lesion centers in Italy. Readmitted traumatic or nontraumatic spinal cord lesion patients were included. Main outcome measures were number of readmissions, their causes, complications on admission, and length of stay. Results: Out of 2070 total admissions of patients with spinal cord lesion, 1056 (51.0%) were readmissions. The median period between the onset of disease and readmission was 3.4 yrs. A program of functional gain was the main cause of readmission (33%). A pressure sore was reported in 20.6% of cases on readmission. Readmission for a program of functional gain was correlated to nontraumatic and incomplete lesions. Readmission necessary for clinical complications was correlated to trau- matic spinal cord lesion and completeness of the lesion. A longer length of stay correlated with cause of readmission, admission to rehabilitation centers, and nontraumatic origin. Conclusions: Readmissions account for more than half of total admis- sions to centers for spinal cord lesion in Italy. The main burden is represented by a program of functional gain, pressure sores, and urolog- ical complications. Key Words: Spinal Cord Lesion, Epidemiology, Rehabilitation, Complications, Pres- sure Sores, Length of Stay, Readmissions. August 2008 Care of Postacute SCI Patients in Italy 619 ORIGINAL RESEARCH ARTICLE Spinal Cord Injury