Epidemiology of traumatic cervical spinal cord injury in ICU

Abstract

Objective To investigate the epidemiological characteristics of traumatic cervical spinal cord injury (TCSCI) in ICU. Method The data of patients with TCSCI admitted from October 2010 to March 2016 in the intensive care unit were retrospectively studied. The general epidemiological data included: gender, age, marital status, occupation, cause of injury, injury severity, injured segment (ASIA grade), and complications were collected. Results There were 109 patients identified to have TCSCI with mean age of 53.72 ± 14.86 years (25.69% patients in the range of 60-69 years old). The male to female ratio was 9: 1, and the most were married. The majority of individuals were retired (30.27%), and the main causes of injury were traffic accidents and tumble. The C5 segment of the spine was the most vulnerable to be injured, and then the C4 segment was the nest in turn. There were up to 30.28% patients suffered from multiple injuries, and 26.61% patients also had a craniocerebral injury. Bedsore and respiratory system complications were the two leading complications, and 83 patients suffered from at least one system dysfunction with respiratory dysfunction accounted for 98.79% and circulatory dysfunction accounted for 65.06%. Fifty-one patients presented more than two system dysfunctions (46.79%). Twenty patients (18.35%) died. Conclusion Patients with TCSCI in ICU presented specially characteristic features. Traffic accidents were the main cause of TCSCI, and fall accidents were one of the main causes in the elderly. The mortality of TCSCI was high, especially in males. The complication rate was relatively high and the most common complications were water and electrolyte disturbance and respiratory dysfunction. Multiple organ dysfunction incidences might be associated with the ASIA grades. Key words: Spinal cord injury; Traumatic cervical spinal cord injury; Epidemiology; ASIA; Vehicle accident; Complications; Multiple organ dysfunction; Mortality