Risk factors associated with mortality after traumatic cervical spinal cord injury
| Autor: | Takayuki Higashi, MD, Hideto Eguchi, MD, Yusuke Wakayama, MD, Masakatsu Sumi, MD, Tomoyuki Saito, MD, PhD |
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| Jazyk: | angličtina |
| Rok vydání: | 2018 |
| Předmět: | |
| Zdroj: | OTA International, Vol 1, Iss 1, p e003 (2018) |
| Druh dokumentu: | article |
| ISSN: | 2574-2167 00000000 |
| DOI: | 10.1097/OI9.0000000000000003 |
| Popis: | Abstract. Objectives:. To investigate the mortality rate following cervical spinal cord injury (SCI) injury and analyze the associated risk factors. Design:. Retrospective cohort study. Setting:. One Level 1 trauma center. Patients/participants:. A cohort of 76 patients with traumatic cervical SCI was reviewed between January 2010 and May 2015, of which 54 patients were selected for the present retrospective study. Intervention:. Operative or conservative treatment. Main outcome measurements:. The following patient parameters were analyzed; age, sex, American Spinal Injury Association (ASIA) impairment scale, neurological impairment level, injury mechanism, radiological findings, treatment, tracheostomy rate, and mortality. Results:. The mean age of the patient cohort was 65 ± 17 years, with 11 females (20%) and 43 males (80%). A total of 16 (30%), 4 (7%), 22 (41%), and 12 patients (22%) were scored A, B, C, and D, respectively, on the ASIA impairment scale. Most of the injuries were at the C4 (30%) and C5 (33%) levels. Falls from standing (35%) and heights (39%) were the most common injury mechanisms. SCI in 40 patients (74%) occurred without major fracture or dislocation. Surgery was performed on 26 patients. The overall mortality was 19%. Patients in the deceased group were significantly older at the time of injury, compared with those who survived. Paralysis had been more severe in the deceased group. A significantly high number of patients in the deceased group received a tracheostomy. When analyzed using a multivariate logistic regression model, an ASIA impairment scale of A was a significant risk factor for mortality. Conclusions:. The risk factors associated with mortality were age, tracheostomy, and an ASIA impairment scale of A, the latter had the highest risk. Level of Evidence:. Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence. |
| Databáze: | Directory of Open Access Journals |
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