Trends in demographics and markers of injury severity in traumatic cervical spinal cord injury.

Title

Trends in demographics and markers of injury severity in traumatic cervical spinal cord injury.

Creator

Aarabi B; Albrecht JS; Simard JM; Chryssikos T; Schwartzbauer G; Sansur CA; Crandall K; Gertner M; Howie B; Wessell A; Cannarsa G; Caffes N; Oliver J; Shanmuganathan K; Olexa J; Lomangino CD; Scarboro M

Publisher

Journal of Neurotrauma

Date

2021
2021-01-08

Description

Over the past four decades, there have been progressive changes in the epidemiology of traumatic spinal cord injury (tSCI). We assessed trends in demographic and injury-related variables in traumatic cervical spinal cord injury (tCSCI) patients over an 18-year period at a single Level I trauma center. We included all magnetic resonance imaging-confirmed tCSCI patients ≥15 years of age for years 2001-2018. Among 1420 patients, 78.3% were male with a mean age 51.5 years. Etiology included falls (46.9%), motor vehicle collisions (MVCs; 34.2%), and sports injuries (10.9%). Median American Spinal Injury Association (ASIA) Motor Score (AMS) was 44, complete tCSCI was noted in 29.6% of patients, fracture dislocations were noted in 44.7%, and median intramedullary lesion length (IMLL) was 30.8 mm (complete injuries 56.3 mm and incomplete injuries 27.4 mm). Over the study period, mean age and proportion of falls increased (p < 0.001) whereas proportion attributable to MVCs and sports injuries decreased (p < 0.001). Incomplete injuries, AMS, and the proportion of patients with no fracture dislocations increased whereas complete injuries decreased significantly. IMLL declined (p = 0.17) and proportion with hematomyelia did not change significantly. In adjusted regression models, increase in age and decreases in prevalence of MVC mechanism and complete injuries over time remained statistically significant. Changes in demographic and injury-related characteristics of tCSCI patients over time may help explain the observed improvement in outcomes. Further, improved clinical outcomes and drop in IMLL may reflect improvements in initial risk assessment and pre-hospital management, advances in healthcare delivery, and preventive measures including public education.

Subject

cervical; epidemiology; MRI; spinal cord injury; trauma

Rights

Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).

Format

journalArticle

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ISSN

1557-9042 0897-7151

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Update Year & Number

January 2021 List

Citation

Aarabi B; Albrecht JS; Simard JM; Chryssikos T; Schwartzbauer G; Sansur CA; Crandall K; Gertner M; Howie B; Wessell A; Cannarsa G; Caffes N; Oliver J; Shanmuganathan K; Olexa J; Lomangino CD; Scarboro M, “Trends in demographics and markers of injury severity in traumatic cervical spinal cord injury.,” NEOMED Bibliography Database, accessed July 2, 2022, https://neomed.omeka.net/items/show/11494.

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