Spinal cord injury: epidemiologycal study of 386 cases with emphasis on those patients admitted more than four hours after the trauma (original) (raw)
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Traumatic injury to the spinal cord. Prevalence in Brazilian hospitals
Paraplegia, 1992
Traumatic spinal cord lesions have a worldwide high morbidity and mortality, and in many developed countries the problem has received special attention, based on epidemiological studies. In Brazil these studies have been restricted to institutional data. In 1988 a survey conducted by the Integrated System of Traumatology and Orthopaedics, covering 36 public hospitals from 7 Brazilian capitals, revealed a point prevalence of 8.6% (108 patients) with spinal cord injury, aged from 6-56 years; 81% were men. The most frequent causes were traffic accidents (42%), firearms (27%) and falling from heights (15%). The main complications were pressure ulcers (54%) and urinary infections (32%).
Profile of Spinal Cord Trauma Victims Treated at a Reference Unit in São Paulo
Coluna/Columna
Introduction: Spinal cord trauma (SCT) is an important cause of morbidity and mortality around the world. It affects different age groups, especially young adults who are victims of high-energy trauma. The most effective way to reduce the incidence of spinal cord trauma and its consequences is through preventive campaigns and control and surveillance measures through public agencies. The objective of this study is to outline the epidemiological profile of patients with spinal cord trauma attended at a tertiary care center in the city of São Paulo. Methods: Retrospective, cross-sectional study performed at a reference center for the care of patients with spinal cord injury in the State of São Paulo. Data were collected from the medical records of patients with spinal cord trauma between 2012 and 2016. Results: Of the 515 patients with spinal trauma, 153 (29.7%) had spinal cord injury of which 131 (85.62%) were male, and 22 (14.37%) were female, in a ratio of approximately 6:1. The me...
Spinal cord injuries – Epidemiology in Portugal's central region
Spinal Cord, 1998
This study concerns spinal cord injuries (SCI) in a region of Portugal with a population of 1 721 650 inhabitants. Legislation has made it possible to identify deaths occurring during collection and transport. Between 1989 and 1992, 398 new cases of spinal cord injuries were identi®ed, of which 77% were male and 23% female. The average age was 50, with a range of between 1 and 92. As far as the type of injury is concerned, there were 154 isolated SCI (38.7%); in 120 cases (30.1%) there were multiple associated injuries; in 66 cases (16.6%) there was an associated traumatic brain injury; in 34 cases (8.5%) there was an associated trauma of the thorax. In the hospitals concerned no Injury Severity Score (ISS) was carried out during hospitalization. Sixty-four (16%) were dead upon arrival at hospital, and 159 (40%) died before release. The average length of hospitalization was 26.6 days, with the maximum being 539 days. The annual incidence rate is 57.8 new cases per million inhabitants, including those who died before being admitted to hospital. The annual survival rate is 25.4 new cases per million inhabitants. The death rate is very high during the ®rst week, peaking during the ®rst 24 h.
Arquivos Brasileiros de Neurocirurgia: Brazilian Neurosurgery, 2021
Objective To analyze the epidemiological profile of patients with spinal cord injury treated at POLEM – Associação de Apoio às Pessoas com Lesão Medular (Association for Supporting People with Spinal Cord Injury). Method The population studied comprised 113 patients with spinal cord injury, of traumatic or nontraumatic etiology, and the data obtained were compared with those of other institutions. Results Of the 113 patients, 70.8% were male and 29.2% female. Traumatic lesions were responsible for 54% of the patients, and nontraumatic for 46%. Of the patients with traumatic injury, 90.2% were male, the main cause being traffic accidents. In nontraumatic lesions, women were the most affected, 51.9%; and dysraphism and myelitis were the main causes (31% and 21%, respectively). Conclusion The results showed an important incidence of spinal cord injury due to trauma, mainly affecting young individuals of productive age and low educational level, representing high economic and social cos...
Epidemiology of Post-Traumatic Spinal Cord Injury in a Tertiary Hospital
Acta Ortopédica Brasileira
Objective: to outline the profile of risk groups for spinal cord injury (SCI) at the Hospital de Clinicas de Campinas by an epidemiological survey of 41 patients with SCI. Methods: Data from patients with SCI were collected and analyzed: demographic data, level of neurological injury, visual analogue scale (VAS), and the current American Spinal Injury Association (ASIA) impairment scale (AIS), using questionnaires, medical records, and imaging tests. Fisher’s exact test was used to assess the relationship between categorical variables, Spearman’s correlation coefficient was used for numerical variables, and the Mann-Whitney and Kruskal-Wallis tests were used to analyze the relationship between categorical and numerical variables, with significance level of 5%. Results: There was a prevalence of 82.9% of men, a mean age of 26.5 years, and traffic accidents as the cause of SCI in 56.1% of cases. Conclusion: Results suggest the importance of SCI prevention campaigns directed at this po...
Risk Factors for Mortality in Traumatic Cervical Spinal Cord Injury: Brazilian Data
The Journal of Trauma: Injury, Infection, and Critical Care, 2009
Background: Predictive factors for mortality are different among countries; knowledge of risk factors is important for planning strategies to reduce mortality in trauma. The objective of this study was to identify predictors of death in traumatic cervical spinal cord injury (TSCI) in Brazil. Methods: From 2001 to 2005, 84 patients with clinically detectable TSCI were identified in this retrospective study. For each patient, neurologic and associated injuries, physiologic variables, complications, treatment, and hospital mortality were recorded. Bivariate and multivariate logistic regression analyses were done to identify predictors of mortality. Results: Twenty-two (26.2%) patients died in hospital. Car crash (39%) and falls (37.85) were the most frequent causes of trauma. The causes of death were as follows: neurologic, 8 (36.4%); respiratory, 4 (18.2%); septic complications, 2 (9.1%); venous thrombosis and embolism, 2 (9.1%); and undetermined, 4 (18.2%). Bivariate analysis identified absent neurologic function (risk ratios [RR] ϭ 4.5; 95% confidence intervals [CI], 1.6 -12.7), high injury severity score (p ϭ 0.001) and low revised trauma score (p ϭ 0.001); Glasgow Coma Scale (GCS) score Ͻ9 (RR ϭ 47.4; 95% CI, 5.4 -413.2); shock at admission (RR ϭ 2.5; 95% CI, 0.8 -7.9); vasopressor use (RR ϭ 25.8; 95% CI, 6.1-109.6); mechanical ventilation (RR ϭ 31.9; 95% CI, 6.6 -154.0); acute renal insufficiency (RR ϭ 10.0; 95% CI, 0.98 -102.1) as associated with mortality. The mainly independents predictors for mortality were GCS score Ͻ9 and vasopressor use. Lowest mortality rate (5.2%) was observed for patients with TSCI alone. Conclusions: GCS score Ͻ9, mechanical ventilation, and vasopressor use were predictors of mortality with TCSI, and if these risk factors were absent, we observed low mortality rate.
The Internet Journal of Orthopedic Surgery, 2007
Background: Spinal Cord Injury (SCI) is still a major cause of morbidity and mortality in our environment. It posses a management challenge to the Orthopaedic surgeons in an environment of scarce manpower and specialized facilities. Aim: To establish the pattern of SCI in Calabar and contribute to the existing national data on this injury as well as highlighting the deficiencies in our peculiar environment with a view to improving them. Methods: A prospective research protocol by questionnaire was designed for all patients presenting with spinal cord injury at the University of Calabar Teaching between February 2005 and January 2006. The parameters of study included patients' demographics, mode and pattern of injuries, neurologic grade pre and post treatment, complications and clinical outcome. Results: Fourteen spinal cord injured patients were admitted during the study period. Mean age was 36years with a male/female ratio of 4:1. Motor vehicle accidents were the most common cause 12 (85.7%). Thirteen (93%) patients were transported to the hospital by bus/car while one patient was brought on a motor cycle. None of the victims of road traffic accident wore protective device nor had any proper pre-hospital care. The commonest site of injury was the lumbar region 6 (43%) while cervical and thoracic regions contributed 5 (35.7%) and 3(21.4%) respectively. Clinical presentation were; paraplegia 11 (78.6%), quadriplegia 2 (14.3%) and spinal shock 1 (7%). Treatment included cast/braces support, drugs and Physiotherapy. Associated injuries included limb factures-4, head injuries-1, rib fractures-1, Splenic-1, bowel injuries-1 and soft tissue lacerations in 2 patients. Mean interval between injury and presentation at hospital was 2 days (2hrs-30days) while the duration of stay in hospital ranged between 4 to 20 weeks. Mortality was 2 (14.3%) Conclusion: Public enlightenment on road safety measures and use of proper protective devices including seat belts and helmet could reduce the high morbidity associated with Spinal cord injuries. More spinal centres and training of more trauma/neurosurgeons are needed.
Spinal cord, 2018
Retrospective cohort. To evaluate the survival outcomes in patients with traumatic spinal cord injury (TSCI). A teaching hospital in Brazil. A total of 434 patients diagnosed with TSCI (2004-2014) were included. Overall survival, standardized mortality ratios (SMR), and causes of death were assessed by Student's t-test, χ test, Kaplan-Meier analysis, and Cox proportional-hazards regression. The mean follow-up was 4.8 years (±3.3 years). Individuals with tetraplegia had a median survival of 11 years, with participants in the paraplegia group not reaching median survival. The overall mortality rate was 37 per 1000 person-years. Age-adjusted SMR was 28.8 (95% CI: 22.8-36). There were 77 deaths with 56 defined causes, of which pneumonia was the most frequent (35.7%). Combined infectious etiologies caused 55.3% of deaths. Multivariate analysis revealed higher mortality among individuals with tetraplegia vs. paraplegia in the first 2 years post injury (HR = 8.28, 95% CI: 2.76-24.80), ...
Turkish Journal of Trauma and Emergency Surgery, 2013
BACKGROUND: Spinal cord injuries result in critical pecuniary and/or non-pecuniary losses due to the developing neurological problems. The objective of this study was to evaluate spinal injuries in terms of clinical severity and prognosis. Spinal injuries lead to serious clinical results due to the high rates of morbidity and mortality; however, there is a lack of reliable information on spinal injuries in our country. METHODS: Following the approval of the Faculty Ethics Committee, this retrospective study was conducted on 91 patients aged ≥18 (59 male, 32 female) with spinal trauma who were admitted to the Emergency Department of Ondokuz Mayis University over three years. The patients were assessed in terms of demographics, clinical severity, developing complications, and mortality. RESULTS: Forty-three patients had complete injuries, while 48 had incomplete injuries. Forty-six patients suffered spinal injuries due to fall from height, 35 patients due to traffic accidents, and 10 patients due to other reasons. Several complications were observed in 52 patients, while no complication occurred in 39 patients. We determined that 19 of 92 patients involved in this study died, while 72 were discharged from the hospital. CONCLUSION: Spinal cord injuries generally result in unfavorable clinical results. Therefore, an appropriate approach (early diagnosis and true treatment) in emergency services has great significance.
Profile of patients admitted for spinal cord injury in public teaching hospital
Revista Médica de Minas Gerais, 2015
The spinal cord injury (TRM) is an important cause of mortality in Brazil. The PRO/PET-Health III, a Federal Government program developed at the Federal University of Minas Gerais, sought to identify the profile of TRM victims assisted in a large general teaching hospital in Belo Horizonte. A cross-sectional, descriptive study, with analysis of electronic medical records of patients admitted for TRM, was conducted to determine its epidemiological profile. The results revealed the age, length of stay, type of injury, trauma etiology, events registration, results of microbial cultures, and drugs used by these patients. It was possible to establish the relationship between the obtained data and those described in the literature and analyze the context of admission of these individuals, showing the importance of a multidisciplinary vision of the people affected by TRM.