64 Complications of metastatic spinal cord compression in a tertiary centre

Background Metastatic spinal cord compression (MSCC) is a recognised complication of cancer and an oncological emergency. This patient group is at increased risk of complications such as bowel/bladder dysfunction and the development of pressure ulcers. Following several reports of pressure damage, we aimed to determine compliance with NICE guidelines for patients with suspected MSCC. Methods A retrospective case-note review was undertaken of 27 patients with suspected MSCC admitted to a tertiary hospital over a six-month period (July 2022-January 2023). Data were collected using standards determined in the NICE 'Spinal metastases and metastatic spinal cord compression' guideline (NG234). Patient data were separated and analysed separately for those with confirmed MSCC, with a specific focus on pressure ulcers and bowel/bladder dysfunction. Results 29.6% (n=8) of Cohort A and 66.7% (n=6) of Cohort B (confirmed MSCC) acquired pressure ulcer damage. Bowel function was assessed at presentation in 96.3% (n=26) and 88.8% (n=8) of Cohort A and B respectively, but formal bowel care plans were only used in 14.8% (n=4) and 44.4% (n=4) of cases (Cohort A and B). 100.0% of both cohorts had bladder function assessed at initial presentation, however bladder care plans were only used in 48.1% and 88.9% of cases (Cohort A and B respectively). Discussion High rates of hospital acquired pressure damage were identified in both cohorts but were particularly high in those with confirmed MSCC highlighting the need for education in this area. Pressure ulcer risk assessments were inconsistent both within the emergency department and on the wards. Whilst bowel and bladder dysfunction were consistently assessed at presentation, subsequent monitoring and management of complications were poor. Neurogenic bowel charts were used infrequently despite clinical indication.