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尼日利亚二级创伤中心脊髓损伤的流行病学和临床结局:一项长达五年的纵向研究。

Epidemiology and clinical outcomes of spinal cord injuries at a level II trauma centre in Nigeria: a longitudinal five year study.

机构信息

Department of Orthopaedic and Trauma Surgery, National Orthopaedic Hospital, PMB 2009, Igbobi, Yaba, Lagos, Nigeria.

出版信息

Int Orthop. 2021 Mar;45(3):665-671. doi: 10.1007/s00264-020-04898-y. Epub 2021 Jan 14.

DOI:10.1007/s00264-020-04898-y
PMID:33443597
Abstract

BACKGROUND

Spinal cord injuries (SCIs) are devastating consequences of traumatic injuries with far-reaching health and socioeconomic implications. The objectives of this study were to describe the epidemiological characteristics of traumatic SCI and to analyse these epidemiological and clinical characteristics.

METHODS

This study was a retrospective observational study. We extracted data from the medical records of all cases of acute traumatic SCI that presented at the hospital between January 2013 and December 2017.

RESULTS

We recorded 99 cases of traumatic SCI over the study period. The patients' mean age was 37.15 ± 13.5 years with a male predominance (68.7%). Working age group accounted for 83.9% of cases. Motor vehicular accident (MVA) and falls accounted for 62.6% and 22.2% respectively. About a third of the cases (32.3%) presented within 24 hours of injury. The most frequently affected level was the cervical spine (63.6%), and complete tetraplegia was the most prevalent clinical pattern (31.3%). American Spinal Injury Association impairment scale (AIS) improved in 31.3% of cases. Twenty-nine patients (30.2%) had morbidity, with 21.2% developing pressure sores. Mortality accounted for 3%.

CONCLUSIONS

Motor vehicular crash and fall-related traumatic SCI affected mostly males and the working age group with complete tetraplegia as the predominating clinical pattern. There is a need for strategic interventions to reduce MVA and improve pre-hospital care and health policies to ensure early definitive care.

摘要

背景

脊髓损伤(SCI)是创伤的严重后果,对健康和社会经济有深远影响。本研究的目的是描述外伤性 SCI 的流行病学特征,并分析这些流行病学和临床特征。

方法

本研究为回顾性观察性研究。我们从 2013 年 1 月至 2017 年 12 月期间在医院就诊的所有急性外伤性 SCI 患者的病历中提取数据。

结果

研究期间共记录了 99 例外伤性 SCI 患者。患者的平均年龄为 37.15±13.5 岁,男性居多(68.7%)。工作年龄组占病例的 83.9%。机动车事故(MVA)和跌倒分别占 62.6%和 22.2%。约三分之一的病例(32.3%)在受伤后 24 小时内就诊。最常受影响的部位是颈椎(63.6%),最常见的临床类型是完全四肢瘫痪(31.3%)。美国脊髓损伤协会损伤量表(AIS)改善了 31.3%的病例。29 例患者(30.2%)出现并发症,其中 21.2%发生压疮。死亡率为 3%。

结论

机动车事故和跌倒相关外伤性 SCI 主要影响男性和工作年龄组,以完全四肢瘫痪为主要临床类型。需要采取战略干预措施来减少 MVA,并改善院前护理和卫生政策,以确保早期的确定性治疗。

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