Download PDF
Arquivos Brasileiros de Neurocirurgia: Brazilian Neurosurgery 2015; 34(02): 097-102
DOI: 10.1055/s-0035-1554899
Original Article | Artigo Original
Thieme Publicações Ltda Rio de Janeiro, Brazil

Prognosis Factors in Patients with Spinal Cord Trauma

Fatores de prognóstico em pacientes com trauma raquimedular
Dionei Freitas de Morais
1   Department of Neurological Science, Faculdade de Medicina de São José do Rio Preto (FAMERP), São José do Rio Preto, São Paulo, Brazil
,
João Simão de Melo Neto
2   Faculdade de Medicina de Marília (FAMEMA), Marília, São Paulo, Brazil
,
Lucas Crociati Meguins
3   Faculdade de Medicina de São José do Rio Preto (FAMERP), São José do Rio Preto, São Paulo, Brazil
,
Antonio Ronaldo Spotti
3   Faculdade de Medicina de São José do Rio Preto (FAMERP), São José do Rio Preto, São Paulo, Brazil
,
Waldir Antonio Tognola
4   MD, Instituto de Neurologia Rio Preto, São José do Rio Preto, São Paulo, Brazil
› Author Affiliations
Further Information

Publication History

28 May 2014

31 March 2015

Publication Date:
29 June 2015 (online)

   Permissions and Reprints

Abstract

Objective Analyze the predictors of prognosis in patients with spinal cord trauma (SCT) in a tertiary hospital.

Method Study prospective with 321 patients. The analysis focused on patient-related data, cause of accident, anatomical distribution, neurologic status, associated injuries, length of hospital stay, and in-hospital complications/mortality.

Results The SCT was more common in men, but women older than 50 years presented a higher risk than men of the same age. Automobile accidents, motorcycle accidents, and gunshots resulted in more injuries associated. The cervical spine involvement was directly related to an increase in the number of associated injuries, complications, and mortality. Already, the neurologic status ASIA-A was associated with an increase in the number of complications, length of stay, and mortality.

Conclusion The predictive factors of prognosis in these patients included age, sex, cause of injury, anatomic distribution, and neurologic status.

Resumo

Objetivo Analisar os preditores de prognóstico em pacientes vítimas de trauma raquimedular (TRM) em um hospital terciário.

Método Estudo prospectivo com 321 pacientes. A análise foi direcionada aos dados relacionados aos pacientes, causa do acidente, distribuição anatômica, status neurológico, lesões associadas, tempo de permanência hospitalar e complicações e mortalidade no hospital.

Resultados O TRM foi mais comum em homens, mas mulheres com idade superior a 50 anos apresentaram mais risco que homens da mesma faixa etária. Ferimento por arma de fogo, acidentes automobilísticos e de motocicleta resultaram em maior número de lesões associadas. O trauma na coluna cervical foi diretamente relacionado a um aumento no número de lesões associadas, complicações e mortalidade. Além disso, o status neurológico ASIA-A foi associado com um aumento no número de complicações, tempo de permanência e mortalidade.

Conclusão Os fatores preditivos de prognóstico nesses pacientes foram: idade, sexo, causa da lesão, distribuição anatômica e status neurológico.

Keywords

traumatology - complications - mortality

Palavras-chave

traumatologia - complicações - mortalidade

Note

This study is part of the dissertation Morais DF carried out at FAMERP, São José do Rio Preto, São Paulo, Brazil.


 

  • References

  • 1 Oliver M, Inaba K, Tang A , et al. The changing epidemiology of spinal trauma: a 13-year review from a level I trauma centre. Injury 2012; 43 (8) 1296-1300
    CrossrefPubMedGoogle Scholar
  • 2 Cunha MLV, da Cunha MLV, Veríssimo DCA, Rehder R, Borba LAB. Epidemiological study of spine fractures at a referral center for spinal disease in Parana. Arq Bras Neurocir. 2012; 31 (4) 179-183
    PubMedGoogle Scholar
  • 3 Dajpratham P, Kongkasuwan R. Quality of life among the traumatic spinal cord injured patients. J Med Assoc Thai 2011; 94 (10) 1252-1259
    PubMedGoogle Scholar
  • 4 Morais DF, de Melo Neto JS, Spotti AR, Meguins LC, Mussi SE, Tognola WA. Image diagnosis of patients submitted to spinal injury. J Bras Neurocir. 2013; 24: 33-39
    PubMedGoogle Scholar
  • 5 Morais DF, de Melo Neto JS, Meguins LC, Mussi SE, Ferraz Filho JRL, Tognola WA. Clinical applicability of magnetic resonance imaging in acute spinal cord trauma. Eur Spine J 2014; 23 (7) 1457-1463
    PubMedGoogle Scholar
  • 6 Wang H, Zhang Y, Xiang Q , et al. Epidemiology of traumatic spinal fractures: experience from medical university-affiliated hospitals in Chongqing, China, 2001–2010. J Neurosurg Spine 2012; 17 (5) 459-468
    CrossrefPubMedGoogle Scholar
  • 7 Holly LT, Kelly DF, Counelis GJ, Blinman T, McArthur DL, Cryer HG. Cervical spine trauma associated with moderate and severe head injury: incidence, risk factors, and injury characteristics. J Neurosurg 2002; 96 (3, Suppl): 285-291
    PubMedGoogle Scholar
  • 8 Paiva WS, Oliveira AM, Andrade AF, Amorim RL, Lourenço LJ, Teixeira MJ. Spinal cord injury and its association with blunt head trauma. Int J Gen Med 2011; 4: 613-615
    PubMedGoogle Scholar
  • 9 Ditunno Jr JF, Young W, Donovan WH, Creasey G ; American Spinal Injury Association. The international standards booklet for neurological and functional classification of spinal cord injury. Paraplegia 1994; 32 (2) 70-80
    CrossrefPubMedGoogle Scholar
  • 10 Knútsdóttir S, Thórisdóttir H, Sigvaldason K, Jónsson Jr H, Björnsson A, Ingvarsson P. Epidemiology of traumatic spinal cord injuries in Iceland from 1975 to 2009. Spinal Cord 2012; 50 (2) 123-126
    CrossrefPubMedGoogle Scholar
  • 11 Van Den Berg M, Castellote JM, Mahillo-Fernandez I, de Pedro-Cuesta J. Incidence of traumatic spinal cord injury in Aragón, Spain (1972–2008). J Neurotrauma 2011; 28 (3) 469-477
    CrossrefPubMedGoogle Scholar
  • 12 Hagen EM, Eide GE, Rekand T, Gilhus NE, Gronning M. A 50-year follow-up of the incidence of traumatic spinal cord injuries in Western Norway. Spinal Cord 2010; 48 (4) 313-318
    CrossrefPubMedGoogle Scholar
  • 13 Rhee P, Kuncir EJ, Johnson L , et al. Cervical spine injury is highly dependent on the mechanism of injury following blunt and penetrating assault. J Trauma 2006; 61 (5) 1166-1170
    CrossrefPubMedGoogle Scholar
  • 14 Aarabi B, Harrop JS, Tator CH , et al. Predictors of pulmonary complications in blunt traumatic spinal cord injury. J Neurosurg Spine 2012; 17 (1, Suppl): 38-45
    CrossrefPubMedGoogle Scholar
  • 15 Santos EA, Santos Filho WJ, Possatti LL, Bittencourt LR, Fontoura EA, Botelho RV. Clinical complications in patients with severe cervical spinal trauma: a ten-year prospective study. Arq Neuropsiquiatr 2012; 70 (7) 524-528
    CrossrefPubMedGoogle Scholar
  • 16 Kawu AA, Alimi FM, Gbadegesin AA , et al. Complications and causes of death in spinal cord injury patients in Nigeria. West Afr J Med 2011; 30 (4) 301-304
    PubMedGoogle Scholar
  • 17 Tollefsen E, Fondenes O. Respiratory complications associated with spinal cord injury. Tidsskr Nor Laegeforen 2012; 132 (9) 1111-1114
    CrossrefPubMedGoogle Scholar
  • 18 Schoenfeld AJ, McCriskin B, Hsiao M, Burks R. Incidence and epidemiology of spinal cord injury within a closed American population: the United States military (2000–2009). Spinal Cord 2011; 49 (8) 874-879
    CrossrefPubMedGoogle Scholar
  • 19 Ning GZ, Wu Q, Li YL, Feng SQ. Epidemiology of traumatic spinal cord injury in Asia: a systematic review. J Spinal Cord Med 2012; 35 (4) 229-239
    CrossrefPubMedGoogle Scholar
  • 20 Ibrahim A, Lee KY, Kanoo LL , et al. Epidemiology of spinal cord injury in Hospital Kuala Lumpur. Spine 2013; 38 (5) 419-424
    CrossrefPubMedGoogle Scholar
  • 21 Morais DF, Spotti AR, Cohen MI, Mussi SE, de Melo Neto JS, Tognola WA. Perfil epidemiológico de pacientes com traumatismo raquimedular atendidos em hospital terciário. Coluna/Columna 2013; 12 (2) 149-152
    CrossrefPubMedGoogle Scholar
  • 22 Marcon RM, Cristante AF, Teixeira WJ, Narasaki DK, Oliveira RP, de Barros Filho TE. Fractures of the cervical spine. Clinics (Sao Paulo) 2013; 68 (11) 1455-1461
    CrossrefPubMedGoogle Scholar
  • 23 Lourenco LJO, Alves EM, Andrade AF. Spine injuries and severe or moderate traumatic head injuries. Coluna/Columna. 2008; 7 (2) 143-145
    PubMedGoogle Scholar