From the Division of Neurosurgery, Department of Surgery, University of Saskatchewan, Saskatoon, Sask. (Ahmed, Fourney); the Rick Hansen Institute, Vancouver, B.C. (Humphreys, Rivers); and the Waakebiness-Bryce Institute for Indigenous Health, University of Toronto, Toronto, Ont. (Jeffrey).
Can J Surg. 2020 Jun 4;63(3):E315-E320. doi: 10.1503/cjs.012819.
People of Aboriginal (Indigenous) ancestry are more likely to experience traumatic spinal cord injury (TSCI) than other Canadians; however, outcome studies are limited. This study aims to compare Aboriginal and non-Aboriginal populations with acute TSCI with respect to preinjury baseline characteristics, injury severity, treatment, outcomes and length of stay.
This was a retrospective analysis of participants with a TSCI who were enrolled in the prospective Rick Hansen Spinal Cord Injury Registry (RHSCIR), Saskatoon site (Royal University Hospital), between Feb. 13, 2010, and Dec. 17, 2016. Demographic, injury and management data were assessed to identify any differences between the populations.
Of the 159 patients admitted to Royal University Hospital with an acute TSCI during the study period, 62 provided consent and were included in the study. Of these, 21 self-identified as Aboriginal (33.9%) and 41 as non-Aboriginal (66.1%) on treatment intake forms. Compared with non-Aboriginal participants, Aboriginal participants were younger, had fewer medical comorbidities, had a similar severity of neurologic injury and had similar clinical outcomes. However, the time to discharge to the community was significantly longer for Aboriginal participants (median 104.0 v. 34.0 d, p = 0.016). Although 35% of non-Aboriginal participants were discharged home from the acute care site, no Aboriginal participants were transferred home directly.
This study suggests a need for better allocation of resources for transition to the community for Aboriginal people with a TSCI in Saskatchewan. We plan to assess outcomes from TSCI for Aboriginal people across Canada.
与其他加拿大人相比，原住民（土著）更容易经历创伤性脊髓损伤（TSCI）；然而，相关研究结果有限。本研究旨在比较急性 TSCI 的原住民和非原住民人群，比较两组人群的基线特征、损伤严重程度、治疗、结果和住院时间。
这是对 2010 年 2 月 13 日至 2016 年 12 月 17 日期间参加前瞻性 Rick Hansen 脊髓损伤注册研究（RHSCIR）、萨斯卡通站点（皇家大学医院）的 TSCI 患者的回顾性分析。评估人口统计学、损伤和管理数据，以确定两组人群之间的任何差异。
在研究期间，皇家大学医院收治的 159 例急性 TSCI 患者中，有 62 例患者提供了同意并纳入研究。其中，21 例（33.9%）在治疗摄入表中自我认定为原住民，41 例（66.1%）为非原住民。与非原住民参与者相比，原住民参与者更年轻，合并症更少，神经损伤严重程度相似，临床结果相似。但是，原住民参与者出院到社区的时间明显更长（中位数 104.0 天对 34.0 天，p = 0.016）。尽管 35%的非原住民参与者从急性护理地点出院回家，但没有原住民参与者直接转回家。
本研究表明，萨斯喀彻温省原住民 TSCI 患者在向社区过渡方面需要更好地分配资源。我们计划评估加拿大各地原住民 TSCI 的结果。
