Higashi Takayuki, Eguchi Hideto, Wakayama Yusuke, Sumi Masakatsu, Saito Tomoyuki
Department of Orthopaedic Surgery, Yokohama City University, Kanagawa, Japan.
OTA Int. 2018 May 16;1(1):e003. doi: 10.1097/OI9.0000000000000003. eCollection 2018 May.
To investigate the mortality rate following cervical spinal cord injury (SCI) injury and analyze the associated risk factors.
Retrospective cohort study.
One Level 1 trauma center.
PATIENTS/PARTICIPANTS: A cohort of 76 patients with traumatic cervical SCI was reviewed between January 2010 and May 2015, of which 54 patients were selected for the present retrospective study.
Operative or conservative treatment.
The following patient parameters were analyzed; age, sex, American Spinal Injury Association (ASIA) impairment scale, neurological impairment level, injury mechanism, radiological findings, treatment, tracheostomy rate, and mortality.
The mean age of the patient cohort was 65 ± 17 years, with 11 females (20%) and 43 males (80%). A total of 16 (30%), 4 (7%), 22 (41%), and 12 patients (22%) were scored A, B, C, and D, respectively, on the ASIA impairment scale. Most of the injuries were at the C4 (30%) and C5 (33%) levels. Falls from standing (35%) and heights (39%) were the most common injury mechanisms. SCI in 40 patients (74%) occurred without major fracture or dislocation. Surgery was performed on 26 patients. The overall mortality was 19%. Patients in the deceased group were significantly older at the time of injury, compared with those who survived. Paralysis had been more severe in the deceased group. A significantly high number of patients in the deceased group received a tracheostomy. When analyzed using a multivariate logistic regression model, an ASIA impairment scale of A was a significant risk factor for mortality.
The risk factors associated with mortality were age, tracheostomy, and an ASIA impairment scale of A, the latter had the highest risk.
Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
调查颈脊髓损伤（SCI）后的死亡率，并分析相关危险因素。
回顾性队列研究。
一家一级创伤中心。
患者/参与者：2010年1月至2015年5月期间对一组76例创伤性颈脊髓损伤患者进行了回顾，其中54例患者被选入本回顾性研究。
手术或保守治疗。
分析以下患者参数；年龄、性别、美国脊髓损伤协会（ASIA）损伤分级、神经损伤水平、损伤机制、影像学检查结果、治疗方法、气管切开率和死亡率。
患者队列的平均年龄为65±17岁，其中女性11例（20%），男性43例（80%）。在ASIA损伤分级中，分别有16例（30%）、4例（7%）、22例（41%）和12例患者（22%）被评为A、B、C和D级。大多数损伤发生在C4（30%）和C5（33%）水平。站立时摔倒（35%）和高处坠落（39%）是最常见的损伤机制。40例患者（74%）的脊髓损伤发生时无严重骨折或脱位。26例患者接受了手术。总体死亡率为19%。与存活患者相比，死亡组患者受伤时年龄明显更大。死亡组瘫痪情况更严重。死亡组中有大量患者接受了气管切开术。使用多因素逻辑回归模型分析时，ASIA损伤分级为A级是死亡率的显著危险因素。
与死亡率相关的危险因素是年龄、气管切开术和ASIA损伤分级为A级，其中后者风险最高。
治疗性三级。有关证据水平的完整描述，请参阅作者须知。
