scholarly journals Cervical fractures with associated spinal cord injury in children and adolescents: epidemiology, costs, and in-hospital mortality rates in 4418 patients

2015 ◽  
Vol 9 (3) ◽  
pp. 171-175 ◽  
Author(s):  
Amit Jain ◽  
Jaysson T. Brooks ◽  
Sandesh S. Rao ◽  
Michael C. Ain ◽  
Paul D. Sponseller
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Hospital Mortality ◽  
Children And Adolescents ◽  
Mortality Rates ◽  
Cervical Fractures ◽  
Cord Injury

scholarly journals Trending Racial and Socioeconomic Inequality in the Surgical Management and Outcome of Traumatic Cervical Spinal Cord Injury With Fracture In the USA From 1998 to 2009

Neurosurgery ◽  
2019 ◽  
Vol 66 (Supplement_1) ◽  
Author(s):  
Alexander Dru ◽  
Dan Neal ◽  
W Christopher Fox ◽  
Brian Lim Hoh ◽  
Daniel J Hoh
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Socioeconomic Status ◽  
Hospital Mortality ◽  
Cervical Spinal Cord ◽  
Cervical Spinal Cord Injury ◽  
Lower Odds ◽  
Discharge Disposition ◽  
Treatment Type ◽  
Cord Injury

Abstract INTRODUCTION Advances in treatment of traumatic cervical spinal cord injury with fracture (TCSCIF) have led to significant improvements in clinical outcomes; however, progress in healthcare is seldom ubiquitous across demographic groups. We explored if disparities in treatment and outcome after TCSCIF exist across race and socioeconomic status. METHODS We queried the Nationwide Inpatient Sample database from 1998 to 2009 for TCSCIF hospitalizations. Multivariate analysis was used to identify the correlation between socioeconomic status and race to treatment type and outcome. RESULTS There were 21 985 admissions for TCSCIF. In all 66.9% had a favorable discharge disposition. In-hospital mortality rate was 12.5%. In all 43.7% underwent surgery. Overall, surgery was associated with lower in-hospital mortality (OR 0.30, 95% CI 0.27-0.34, P < .01) and better discharge disposition (OR 0.68, 95% CI 0.62-0.74, P < .01) vs nonsurgical or no intervention. Controlling for race and socioeconomic status demonstrated higher status (HS) non-Caucasians had lower odds of receiving surgery than HS Caucasians (OR 0.89, 95% CI 0.81-0.97, P = .01). LSES non-Caucasians had lower odds of receiving surgery than HS Caucasians (OR 0.83, 95% CI 0.73-0.94, P < .01). HS non-Caucasians had lower odds of receiving surgery than LSES Caucasians (OR 0.87, 95% CI 0.77-0.99, P = .03). LSES non-Caucasians had lower odds of receiving surgery than LSES Caucasians (OR 0.82, 95% CI 0.71-0.94, P = .01). For favorable discharge status HS non-Caucasians, LSES non-Caucasians, and LSES Caucasians all had lower odds of favorable discharge compared to HS Caucasians (OR 0.83, 95% CI 0.73-0.95, P = .01/OR 0.69, 95% CI 0.59-0.81, P < .01/OR 0.75, 95% CI 0.66-0.85, P < .01), respectively. CONCLUSION In our multivariate model that controlled for race and socioeconomic status in the setting of TCSCIF, race (but not socioeconomic status) was a factor in receiving surgery and both race and LSES impacted favorable discharge.

Therapeutic trial of hypercarbia and hypocarbia in acute experimental spinal cord injury

1984 ◽  
Vol 61 (5) ◽  
pp. 925-930 ◽  
Author(s):  
Ronald W. J. Ford ◽  
David N. Malm
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Spinal Cord Injuries ◽  
Mortality Rates ◽  
Therapeutic Trial ◽  
Tissue Preservation ◽  
Content Type ◽  
Experimental Spinal Cord Injury ◽  
Cord Injury ◽  
Fine Print

✓ Hypocarbia, normocarbia, or hypercarbia was maintained for an 8-hour period beginning 30 minutes after acute threshold spinal cord injuries in cats. No statistically significant differences in neurological recovery or histologically assessed tissue preservation were found among the three groups of animals 6 weeks after injury. No animal recovered the ability to walk. It is concluded that maintenance of hypercarbia or hypocarbia during the early postinjury period is no more therapeutic than maintenance of normocarbia. Mortality rates and tissue preservation data suggest, however, that postinjury hypocarbia may be less damaging than hypercarbia.

Acute traumatic quadriplegia: Predictors of in-hospital and six-month mortality

Trauma ◽  
2020 ◽  
Vol 22 (4) ◽  
pp. 300-306
Author(s):  
Ehsan Alimohammadi ◽  
Paniz Ahadi ◽  
Cyrous Rezaee ◽  
Roya Safari-Faramani ◽  
Seyed Reza Bagheri ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Logistic Regression ◽  
Respiratory Failure ◽  
Hospital Mortality ◽  
Logistic Regression Model ◽  
Injury Severity ◽  
Traumatic Spinal Cord Injury ◽  
Multiple Logistic Regression ◽  
Cord Injury

Background Traumatic spinal cord injury is one of the most disastrous and devastating health burdens all over the world with a high mortality rate. The present study aimed to evaluate the predictors of in-hospital and six-month mortality in these patients. Methods The electronic medical records of 87 consecutive patients with acute complete traumatic quadriplegia were reviewed to extract clinical, radiological, and laboratory data. Simple and multiple logistic regression models were used to estimate crude and adjusted odds with 95% confidence interval (CI) ratios for the predictors of in-hospital mortality and six-month mortality. Results There were 48 males and the mean age was 38.67 ± 12.81; in-hospital and six-month mortality were 21.84% and 11.76%, respectively. Traffic road accidents (67.8%) and falls (12.6%) were the most common causes of injury. The univariate analysis demonstrated advanced age, level of injury, late surgery or no surgical intervention, the lack of methylprednisolone therapy, a higher Charlson comorbidity index, the Injury Severity Score, and the presence of respiratory failure or bradycardia on admission were predictors of in-hospital mortality ( p < 0.05). In the final multiple logistic regression model, the level of injury (OR = 0.02 (0.001,0.35), p = 0.008) and the presence of respiratory failure (OR = 2.37 (0.03,13.88), p = 0.024) were the only predictors of in-hospital mortality. The univariate model showed that the level of injury, respiratory failure on admission, and the Injury Severity Score were the predictors of six-month mortality; however, the level of injury was the only predictor of the six-month mortality (OR = 1.12 (0.99, 1.27), p = 0.028) according to the multiple logistic regression model. Conclusions Several factors could affect in-hospital and six-month mortality in patients with traumatic spinal cord injury. Our findings demonstrated the level of injury and respiratory failure on admission as independent predictors of in-hospital mortality in these patients. Furthermore, the level of injury was the only independent predictor of six-month mortality in the present study.

Autonomic dysreflexia during urodynamics in children and adolescents with spinal cord injury or severe neurologic disease

2015 ◽  
Vol 11 (1) ◽  
pp. 32.e1-32.e4 ◽  
Author(s):  
Stephen Canon ◽  
Annashia Shera ◽  
Nhan Marc Hieu Phan ◽  
Lynne Lapicz ◽  
Tanya Scheidweiler ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Children And Adolescents ◽  
Autonomic Dysreflexia ◽  
Neurologic Disease ◽  
Cord Injury
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