Kattail Deepa, Furlan Julio C, Fehlings Michael G
Spinal Program, Krembil Neuroscience Centre, Toronto Western Hospital, University Health Network, Toronto, Ontario M5T 2S8, Canada.
J Trauma. 2009 Nov;67(5):936-43. doi: 10.1097/TA.0b013e3181a8b431.
Because relevant changes in the epidemiology of the traumatic spinal cord injury (SCI) has been reported, we sought to examine the demographics, injury characteristics, and clinical outcomes of patients with spine trauma who have been treated in our spine trauma center.
All consecutive patients with acute spine trauma who were admitted in our center from 1996 to 2007 were included. Comparisons among the four triennia were performed for demographics, injury characteristics, and clinical outcomes. Also, our 2001/2002 SCI data were compared with the National Trauma Registry (NTR) dataset.
There were 569 patients (394 males, 175 females; ages from 15 to 102 years, mean age of 50 years) who were admitted with acute spine trauma. Although demographic profile has been steady over the last four triennia, the frequency of more severe spine trauma at the lumbosacral levels due to falls has increased overtime. The mean length of stay and in-hospital mortality rates have not significantly changed during the past 12 years. Our in-hospital mortality rate (4%) was significantly lower than the provincial rate from the Ontario Trauma Registry (7.5%; p = 0.005). Comparisons between our SCI data and the NTR dataset showed significant differences regarding age groups.
Our results indicate that significant differences in the characteristics of acute spine trauma but not demographics have occurred overtime in our institution. Also, there were significant differences between our database and the NTR regarding age distribution. Our reduced in-hospital mortality rates in comparison with the provincial data reinforce the recommendations for early management of SCI patients in a spine trauma center.
由于已有报道称创伤性脊髓损伤(SCI)的流行病学发生了相关变化,我们试图研究在我们脊柱创伤中心接受治疗的脊柱创伤患者的人口统计学特征、损伤特点及临床结局。
纳入1996年至2007年期间在本中心连续收治的所有急性脊柱创伤患者。对四个三年期的患者在人口统计学特征、损伤特点及临床结局方面进行比较。此外,将我们2001/2002年的SCI数据与国家创伤登记处(NTR)数据集进行比较。
共有569例急性脊柱创伤患者入院(男性394例,女性175例;年龄15至102岁,平均年龄50岁)。尽管在过去四个三年期内人口统计学特征保持稳定,但因跌倒导致的腰骶部更严重脊柱创伤的发生率随时间增加。在过去12年中,平均住院时间和院内死亡率没有显著变化。我们的院内死亡率(4%)显著低于安大略省创伤登记处的省级死亡率(7.5%;p = 0.005)。我们的SCI数据与NTR数据集在年龄组方面存在显著差异。
我们的结果表明,在我们机构中,急性脊柱创伤的特征而非人口统计学特征随时间发生了显著变化。此外,我们的数据库与NTR在年龄分布方面存在显著差异。与省级数据相比,我们降低的院内死亡率强化了在脊柱创伤中心对SCI患者进行早期管理的建议。