scholarly journals Length of Hospital Stay in Patients with Spinal Cord Injury

2011 ◽  
Vol 35 (6) ◽  
pp. 798 ◽  
Author(s):  
Hye Jin Jang ◽  
Jieung Park ◽  
Hyung-Ik Shin
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Hospital Stay ◽  
Length Of Hospital Stay ◽  
Cord Injury

scholarly journals Predictors of complications and mortality in traumatic spinal cord injuries

2020 ◽  
Vol 27 (1) ◽  
pp. 59-71
Author(s):  
Lyudmila M. Mirzaeva ◽  
Sergei V. Lobzin ◽  
Inga V. Chistova ◽  
Olga A. Rizahanova ◽  
Alexander A. Dulaev
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Alcohol Consumption ◽  
Hospital Stay ◽  
Spinal Cord Injuries ◽  
Length Of Hospital Stay ◽  
World Health ◽  
Secondary Complications ◽  
Risk Of Death ◽  
Cord Injury

Background. One of the most common causes of death is trauma. The World Health Organization predicts a 40 % increase in injuries and injury-related deaths over the next 10 years. Despite the achievements of modern medicine, mortality in spine and spinal cord injuries remains high. This is explained not only by the severity of traumas, but also a large number of secondary complications,.Aim. To study the frequency of complications and the mortality rate of traumatic spinal cord injuries; to identify factors affecting the outcome of such injuries. Materials and methods. A retrospective analysis covered 322 medical records from patients diagnosed with traumatic spinal cord injury and admitted to neurosurgical departments of Saint Petersburg in 2012–2016.Results. Secondary complications (outside of the central nervous system) were found in 33 % cases, with the most common and serious being respiratory complications, pressure ulcers and thromboembolism. Complications more often occurred in elderly patients (over 75), as well as in severe injuries at the cervical and thoracic level. Complications developed significantly more frequently in patients with concomitant traumatic brain injury (TBI) and persons with alcohol consumption before injury. Complications noticeably increased the length of hospital stay and increased the risk of death by 43 times. 14 % of the patients died during primary stay in hospital. The spinal cord injury incompatible with life occurred only in 1 % of the patients. The lethal outcome correlated with age, severity, level of injury, concomitant TBI and alcohol consumption.Conclusion. We have found a high incidence of unfavourable outcomes for traumatic spinal cord injuries (every third patient had at least one complication, every seventh died during the primary hospitalisation). In addition to unmodifiable factors, a statistically significant negative role of alcohol in the frequency of complications and death after spinal cord injury was found. Promoting a healthy lifestyle with low alcohol consumption, optimising preventive and therapeutic measures aimed at reducing the frequency of infectious and thromboembolic complications will improve the outcome of traumatic spinal cord injuries, reduce the length of hospital stay and decrease the economic burden of spinal cord injuries. 

scholarly journals A Prognostic Factor for Prolonged Mechanical Ventilator-Dependent Respiratory Failure after Cervical Spinal Cord Injury : Maximal Canal Compromise on Magnetic Resonance Imaging

2021 ◽  
Vol 64 (5) ◽  
pp. 791-798
Author(s):  
Subum Lee ◽  
Sung Woo Roh ◽  
Sang Ryong Jeon ◽  
Jin Hoon Park ◽  
Kyoung-Tae Kim ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Respiratory Failure ◽  
Hospital Stay ◽  
Cervical Spinal Cord ◽  
Mechanical Ventilator ◽  
Inclusion Criteria ◽  
Resonance Imaging ◽  
Cord Injury

Objective : The period of mechanical ventilator (MV)-dependent respiratory failure after cervical spinal cord injury (CSCI) varies from patient to patient. This study aimed to identify predictors of MV at hospital discharge (MVDC) due to prolonged respiratory failure among patients with MV after CSCI.Methods : Two hundred forty-three patients with CSCI were admitted to our institution between May 2006 and April 2018. Their medical records and radiographic data were retrospectively reviewed. Level and completeness of injury were defined according to the American Spinal Injury Association (ASIA) standards. Respiratory failure was defined as the requirement for definitive airway and assistance of MV. We also evaluated magnetic resonance imaging characteristics of the cervical spine. These characteristics included : maximum canal compromise (MCC); intramedullary hematoma or cord transection; and integrity of the disco-ligamentous complex for assessment of the Subaxial Cervical Spine Injury Classification (SLIC) scoring. The inclusion criteria were patients with CSCI who underwent decompression surgery within 48 hours after trauma with respiratory failure during hospital stay. Patients with Glasgow coma scale 12 or lower, major fatal trauma of vital organs, or stroke caused by vertebral artery injury were excluded from the study.Results : Out of 243 patients with CSCI, 30 required MV during their hospital stay, and 27 met the inclusion criteria. Among them, 48.1% (13/27) of patients had MVDC with greater than 30 days MV or death caused by aspiration pneumonia. In total, 51.9% (14/27) of patients could be weaned from MV during 30 days or less of hospital stay (MV days : MVDC 38.23±20.79 vs. MV weaning, 13.57±8.40; p<0.001). Vital signs at hospital arrival, smoking, the American Society of Anesthesiologists classification, Associated injury with Injury Severity Score, SLIC score, and length of cord edema did not differ between the MVDC and MV weaning groups. The ASIA impairment scale, level of injury within C3 to C6, and MCC significantly affected MVDC. The MCC significantly correlated with MVDC, and the optimal cutoff value was 51.40%, with 76.9% sensitivity and 78.6% specificity. In multivariate logistic regression analysis, MCC >51.4% was a significant risk factor for MVDC (odds ratio, 7.574; p=0.039).Conclusion : As a method of predicting which patients would be able to undergo weaning from MV early, the MCC is a valid factor. If the MCC exceeds 51.4%, prognosis of respiratory function becomes poor and the probability of MVDC is increased.

scholarly journals COMPLICATIONS OF ACUTE TRAUMATIC SPINAL INJURIES IN SAINT PETERSBURG

2020 ◽  
Vol 6 (1) ◽  
pp. 33-42
Author(s):  
S. V. Lobzin ◽  
L. M. Mirzaeva
Keyword(s):  
Quality Of Life ◽  
Risk Factors ◽  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Vertebral Fractures ◽  
Length Of Hospital Stay ◽  
Respiratory Complications ◽  
Traumatic Injuries ◽  
Cord Injury

Almost every sailor during performing his job duties aboard receives injuries of varying severity, among which the most common are deck fractures, including compression vertebral fractures, as well as open and closed vertebral fractures with spinal cord injuries. Besides the recovery of disordered functions of the spinal cord, in cases of spinal cord injury, the fight against numerous neurological, infectious and somatic complications affecting the survival and quality of life of patients is still relevant.Objective: to study the incidence of complications of traumatic injuries of the spinal cord under initial hospitalization, their impact on the length of hospital stay, to identify and evaluate the role of risk factors in the development of complications.Materials and methods. A retrospective cohort study was conducted according to the archived case histories of patients hospitalized in neurosurgical hospitals in St. Petersburg. 311 cases of acute spinal cord injury in 2012–2016 were analyzed.Results: complications not directly related to spinal cord injury, such as bronchitis, pneumonia, bedsores, sepsis, thromboembolism, urinary tract infections, postoperative wound pyogenesis and others (damage to other organs and systems), were found in one third of patients (33,8%), in half of the cases there were multiple complications (2 or more), the most frequent — respiratory (23,5%) and pressure sores (10%). Complications significantly increased the length of hospital stay. The dependence of the frequency of complications on age, the level of spinal cord damage and the severity of the injury was revealed. Risk factors such as concomitant head injury and alcohol intoxication have been found. The revealed positive effect of corticosteroids on the regression of neurological deficit was not statistically confirmed. At the same time, there was a significant increase in the frequency of respiratory complications when using corticosteroids.Conclusion: Knowledge of the factors affecting the incidence of complications, optimization of their prevention and therapy will shorten the duration of hospitalization and improve the prognosis and quality of life of patients. The issue of use of corticosteroid therapy in the acute period of traumatic injuries of the spinal cord remains debatable. When choosing therapeutic tactics for managing patients with spinal trauma, it is necessary to take into account the risk of respiratory complications and carefully evaluate the ratio of benefits to harm. 

scholarly journals Demographic pattern, clinical profile and outcome of traumatic spinal cord injuries at a tertiary care hospital

2015 ◽  
Vol 29 (3) ◽  
pp. 317-322 ◽  
Author(s):  
K. Aswani Kumar ◽  
B.V. Subrahmanyam ◽  
S.V. Phanidra ◽  
S. Satish Kumar ◽  
P.N. Harish ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Hospital Stay ◽  
Spinal Cord Injuries ◽  
Traumatic Spinal Cord Injury ◽  
Lumbar Region ◽  
Care Hospital ◽  
Cord Injury ◽  
The Mean ◽  
Epidemiological Characteristics

Abstract Background: Traumatic spinal cord injury (SCI) is recognized as a serious public health problem resulting in significant morbidity, mortality and permanent disability. The present study is aimed to describe the epidemiological characteristics and outcome of patients with traumatic spinal cord injury in rural tertiary referral care center form South India. Material and methods: The present study was conducted at Narayana Medical College and Hospital, Nellore. All patients admitted and managed for traumatic spinal cord injury were retrieved and data collected in a pre-designed proforma. Patient characteristics, details of etiology, mechanism of injury, level of injury, extent of neurological deficits, details of investigations, details of management and immediate outcome were recorded. Results: A total 152 patients were included in the present study. The mean age was 38.45 years and majority the patients were young adult males. The mean hospital stay was 19.12 days. 71.7% percent patients were non-agriculture workers (mainly involved in construction work) and 28.3% patients were farmers. 61.2% of the patients sustained injuries due to fall from height and 34.2% patients sustained injuries due road traffic accidents. Cervical spine injuries were most common (44.1%), followed by thoraco-lumbar region (36.8%) and dorsal spinal region (19.1%). 9 patients expired in post-injury during hospital stay and all of them had complete cervical spinal cord injury. All patients received aggressive rehabilitation care. Conclusion: In accordance with the literature our results reflect that traumatic spinal cord injuries affect young population and can leave these persons with significant functional and physical morbidity. The major limitation of the study is that it is a single institution based and may not reflect the true spectrum of traumatic spinal cord injuries in the population.

Epidemiological Study of Traumatic Spinal Injuries in Iranian Patients from 2007 to 2017

2020 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Mohamadreza Saatian ◽  
Nayereh Kasiri ◽  
Younes Mohamadi ◽  
Sajjad Sangestani ◽  
Ali Abdoli ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Hospital Stay ◽  
Psychological Health ◽  
Length Of Hospital Stay ◽  
Spinal Injuries ◽  
Cross Sectional ◽  
Significance Level ◽  
Cord Injury ◽  
External Causes ◽  
Type Of Injury

Background: Traumatic spinal cord injury (TSCI) can cause numerous adverse effects on the spinal cord and neural tissues. These injuries may have negative effects on physical and psychological health during the lifespan. Objectives: The present study aimed to investigate the epidemiology of TSCI in patients with trauma admitted to Bessat Hospital of Hamadan between 2007 and 2017. Methods: A cross-sectional study was conducted on 3,219 patients with traumatic spinal injuries admitted to Bessat Hospital of Hamadan between 2007 and 2017. Data were collected from the hospital information system. Data analysis was performed using SPSS. Quantitative data were expressed as mean, standard deviation, and frequency, and qualitative data were analyzed using the chi-square and Fisher's exact tests. The significance level was considered to be less than 0.05. Results: Mortality was significantly associated with gender (P = 0.001), age (P = 0.051), external causes of injury (P = 0.001), and type of injury (P = 0.001). The length of hospital stay was significantly associated with the type of injury (P = 0.001) and external causes of injury (P = 0.001), whereas there was no significant relationship between the length of hospital stay and gender, age, and surgery (P > 0.05). Conclusions: Mortality rates were highest at the age of 55 years or over among other age groups. Thus, effective interventions and programs should be implemented for this age group.

scholarly journals Spinal cord injury after traumatic spine fracture in patients with ankylosing spinal disorders

2017 ◽  
Vol 27 (6) ◽  
pp. 709-716 ◽  
Author(s):  
Frederik R. Teunissen ◽  
Bianca M. Verbeek ◽  
Thomas D. Cha ◽  
Joseph H. Schwab
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Cervical Spine ◽  
Hospital Stay ◽  
Predictive Factors ◽  
Spinal Epidural Hematoma ◽  
Neurological Improvement ◽  
Probability Of Survival ◽  
Cord Injury ◽  
Traumatic Fracture

OBJECTIVESpinal cord injury (SCI) is a major complication of spinal fractures in patients with ankylosing spondylitis (AS) and diffuse idiopathic skeletal hyperostosis (DISH). Due to the uncommon nature of these conditions, existing literature consists of relatively small case series without detailed neurological data. This study aims to investigate the incidence, predictors, and sequelae of SCI in patients with a traumatic fracture of the ankylosed spine.METHODSThe study included all patients older than 18 years of age with AS or DISH who presented to two affiliated tertiary care centers between January 1, 1990, and January 1, 2016, and had a traumatic fracture of the spine. Factors associated with SCI after traumatic fracture were compared using Fisher’s exact tests. Logistic regression was used for the analysis of predictive factors for SCI. For the comparison of probability of survival between patients with and without SCI, Kaplan-Meier methodology was used.RESULTSOne hundred seventy-two patients with a traumatic fracture of an ankylosed spine were included. Fifty-seven patients (34.1%) had an SCI associated with the fracture. The cervical spine was the most fractured region for patients both with (77.2%) and without (51.4%) SCI. A cervical fracture (odds ratio [OR] 2.70, p = 0.024) and a spinal epidural hematoma (SEH) after fracture (OR 2.69, p = 0.013) were predictive of SCI. Eleven patients (19.3%) with SCI had delayed SCI (range 8–230 days). Of 44 patients with SCI and sufficient follow-up, 20 (45.5%) had neurological improvement after treatment. Early and late complication rates were significantly higher (p = 0.001 and p = 0.004) and hospital stay was significantly longer (p = 0.001) in patients with SCI. The probability of survival was significantly lower in the SCI group compared with the non-SCI group (p = 0.006).CONCLUSIONSThe incidence of SCI was high after fracture of the spine in patients with AS and DISH. Predictive factors for SCI after fracture were a fracture in the cervical spine and an SEH following fracture. One-fifth of the patients with SCI had delayed SCI. Patients with SCI had more complications, a longer hospital stay, and a lower probability of survival. Less than half of the patients with SCI showed neurological improvement.

scholarly journals Intra-hospital complications in acute traumatic spinal cord injury

2018 ◽  
Vol 25 (1) ◽  
pp. 36-39
Author(s):  
Victor Figueiredo Leite ◽  
Daniel Rubio de Souza ◽  
Marta Imamura ◽  
Linamara Rizzo Battistella
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Major Trauma ◽  
Length Of Hospital Stay ◽  
Cross Sectional Study ◽  
Traumatic Spinal Cord Injury ◽  
Sectional Study ◽  
Cross Sectional ◽  
Cord Injury ◽  
Surgical Corrections

There is scarce data about intra-hospital complications in acute traumatic spinal cord injury (TSCI). Objective: To report characteristics of complications in patients with TSCI in a major trauma center. Method: This is a cross-sectional study with 434 patients with acute TSCI from 2004 to 2014. Outcomes were frequency and description of complications, length of hospital stay (LOS), and causes of increased LOS. Results: Patients presented at least 1 complication in 82.2% of the cases: urinary tract infection (UTI) = 64.4%, pressure ulcers (PU) = 50.6%, and pneumonia = 23.7%. Pneumonia, intubation and cases of surgical corrections for PU were independently associated with increased LOS. Conclusion: UTIs and PUs were the most frequent complications. Investigating its causes and consequences is paramount in the care of patients with SCI. Possible reasons for such complications could comprise time, and frequency of repositioning in bed. Investigating intra-hospital complications is paramount in SCI centers.

Sign in / Sign up

Export Citation Format

Share Document