Regional Epidemiological Investigation Of Traumatic Spinal Cord Injury

?Objective?This study aimed to explore the epidemiological characteristics of inpatients with regional traumatic spinal cord injury in three hospitals of Zhengzhou from 2013 to 2017.The results can provide a scientific basis for reducing the incidence of spinal cord injury(SCI),reducing the location of hospitalization,improving treatment effect and optimizing social medical resources.?Methods?In this study,the medical records of TSCI patients were obtained from 3hospitals in Zhengzhou from 1st January 2013 to 31 th December 2017.Variables were recorded,including hospital name,gender,age,marital status,occupation,basic disease,etiology,the level of injury,America Spinal Injury Association(ASIA)impairment scale,extent of injury,date of admission,location of hospitalization,SLICS/TLICS score,operation or not,time of operation,bleeding volume,associated injuries,complications,whether rehabilitation after discharge,death and its cause.Inclusion criteria: 1.Meet the diagnostic criteria for TSCI;2.The age was15 years old or above;3.Complete medical records and imaging data.The medical records were collected by two researchers and third-party epidemiologists.After strictly checking the data,the data were input into EXCEL registration form,and statistical analysis was conducted with SPSS software.?Results?In this study,a total of 2471 cases of TSCI patients were collected.The ratio of rural to urban was 3.9:1.There were 1,845 male patients(74.7%)and 626 female patients(25.3%),the male-to-female ratio was 2.9:1.The mean age was 49.2±14.2years.Farmers and workers accounted for 42.0% and 25.1% respectively.The main cause of injury was low falls(35.5%),followed by high falls(32.0%)and traffic accidents(22.1%).Cervical spinal cord injury was the most affected level(1574cases),accounting for 63.7%,followed by 522 cases of thoracic spinal cord injury(21.1%).The percentage of grade D was the highest(39.1%)in ASIA impairment scale,followed by grade A(37.9%),grade C(13.4%)and grade B(9.6%).The proportion of the incomplete quadriplegic patients was 37.2%,which was highest.77.3% of the patients accompanied with the associated injuries.Vertebral fracture accounted for the highest proportion(69.9%),followed by thoracic injury(18.3%).22.1% of the patients had complications during hospitalization.The most common complications were respiratory diseases(15.3%)and urinary system diseases(7.8%).In this study,1918 patients received surgical treatment,accounting for 77.6%,and573 patients received conservative treatment,accounting for 23.2%.The mean location of hospitalization was 25.0±30.4 days.29 patients died during orthopedic hospitalization,of which 23 died of respiratory failure due to cervical spinal cord injury,4 died of multiple organ failure,and 2 died of cardiac arrest.?Conclusions?At present,there are few regional or national epidemiological surveys carried out on SCI in China.This study shows that low falls,high falls and traffic accidents were the main causes of spinal cord injuries.Age,occupation and causes of injury have effects on the level of injury,ASIA impairment scale,extent of injury,associated injuries and complications.The main cause of injury in young people is traffic accidents,in middle-aged people is high falls,and in old people is low falls.Respiratory diseases are the main complications during hospitalization and the most common cause of early death in patients with TSCI.After discharge,patients directly transferred to the rehabilitation department account for a small proportion.This study can provide theoretical basis for adjusting the prevention and treatment measures of SCI in Zhengzhou and optimizing the allocation of social medical resources,so as to reduce the occurrence of SCI and improve the standardize the diagnosis and treatment system of SCI.