Abstract
Objective: Characterize victims of spinal cord injury (SCI) associated with traumatic brain injury (TBI) and risk factors. Methods: Study conducted with 52 victims of SCI associated with TBI. The variables studied were: sex; age; marital status; occupation; educational level; religion; etiology and the lesion area; neurological condition by the ASIA scale; associated injuries and potential risk factors. Results: The male (85%), aged between 21-30 years (25%), civil status stable union (56%), low level of education (69%) and the Roman Catholic religion (77%) presented the greater number of victims. Motor vehicle accidents (58%) were the main etiology. The cervical segment had higher injury risk (RR=3.48, p<0.0001). The neurological status ASIA-E (52%), the syndromic neck pain (35%) and the rate of mild TBI (65%) were the most frequent. Complications occurred in 13 patients with increased frequency of pneumonia (62%). The length of hospital stay was significantly higher (20±28 days) and 17% of patients died. Men (RR=2.14, p=0.028) and individuals exposed to motor vehicle accidents (RR=1.91, p=0.022) showed a higher risk of these lesions concurrently. Moreover, these patients had 2.48 (p<0.01) higher risk of death than victims of SCI alone. Conclusion: The SCI associated with TBI was more frequent in men, young adults, and individuals exposed to motor vehicle accidents. The cervical spine is more likely to be affected. Furthermore, the length of hospitalization is significantly higher and the subjects analyzed have higher risk of death.
Highlights
Of the 321 individuals with spinal cord injury (SCI), 52 patients (85% male) who presented with associated traumatic brain injury (TBI) were studied
Car accident (58%) was the most frequent etiology of SCI associated with TBI
Our study enabled us to ascertain that traffic accidents increase the risk of suffering TBI in victims of SCI, as observed in other studies.[10,12]
Summary
A descriptive, prospective cross-sectional study held at the tertiary reference center, Hospital de Base de São José do Rio Preto, SP, Brazil. Three hundred and twenty-one patients were preselected with a diagnosis of SCI in the period from January 2008 to June 2012. The criterion for inclusion was TBI as an injury associated with SCI. Both diagnoses were confirmed by means of initial clinical and radiological evaluation. The following observations were made: altered levels of consciousness; reports of accentuated pain or symptoms of spinal cord injury with accentuation of these conditions in orthostatism; autonomic dysfunctions, such as priapism, alterations in fecal and urinary continence; and multiple lesions. The patients underwent radiological confirmation using computed tomography and/or magnetic resonance
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