| ?Objective?Retrospective analysis was performed on the medical records of patients with traumatic spinal cord injury(TSCI)in 7 hospitals in Shenyang and Xi'an from 2013 to 2018 in order to analyze the epidemiological characteristics and changes.The results can provide theoretical basis for the formulation of prevention and treatment strategies of spinal cord injury and the rationalization of medical resource allocation.?Method?The study retrospectively investigated the date of 2416 patients with traumatic spinal cord injury(TSCI)in 7 hospitals in Shenyang and Xi'an from June 1,2013 to May 31,2018.Including: age,gender,occupation,admission date,admission time,injury to admission time,cause of injury,level of injury,severity of injury,American Spinal Injury Association score,associated injuries,number of days before surgery,number of days in hospital and hospitalization cost(if there is a hospital transfer,records of the hospital transfer and the situation after the hospital transfer).Inclusion criteria:(1)Injury type is traumatic spinal cord injury;(2)Patients not less than 16 years old.Data collection was performed independently by two researchers and the third-party epidemiological professional researchers.All survey forms were analyzed statistically with SPSS software.?Result?A total of 2416 medical records were eventually incorporated.The total number of patients with spinal cord injury in Shenyang and Xi'an showed an increasing trend,of which 1798(74.42%)were male and 618(25.58%)were female,with a male/female ratio of 2.91%.The age of patients ranges from 16 to 89 years,with an average age of49.19 ±14.35 years(of which the average age was 47.59 ±14.35 years between June1,2013 and May 31,2014 and the average age was 50.89 ±14.34 years between June1,2017 and May 31,2018).The proportion of patients aged 16-45 years decreased from 41.01%(between June 1,2013 and May 31,2014)to 33.45%(between June 1,2017 and May 31,2018)(P<0.05).The proportion of patients over 61 years old increased from 17.76%(between June 1,2017 and May 31,2018)to 25.30%(between June1,2017 and May 31,2018)(P<0.05).Among the injured population,farmers and workers accounted for 48.34% and 12.42% respectively.The main cause of injury was high falls(35.02%),followed by low falls(28.04%),and the rate of low falls was higher and higher in recent years.1407 patients were admitted within 24 hours after injury,accounting for 58.85% of the total,and the average time spent was 11.87±7.80 hours.Among them,326 people(23.01%)had not been transferred to hospital,and the average time spent was 8.72 ±7.68 hours.910 persons were admitted to hospital level II and below for the first time(64.9%),the average time spent was 12.67±7.55 hours,13.83 ±7.64 hours were spent in 136 patients(9.72%)who were admitted to hospital level III at the first time,and 15.26 ±8.37 hours in 23 patients(1.75%)who were transferred twice.The proportion of cervical,thoracic and lumbar or sacrum is55.14%,14.94%,29.92%respectively.Of 1172 patients(48.57%)were suffered from C3-C6 spinal cord injury and the percentage of T12-L3 segment injuries was 35.62%.The percentage of grade D was the highest(54.26%)in ASIA score.The proportion of the incomplete quadriplegic patients was 39.11%,which was highest.There were1762 patients with combined injury in all the patients.The types and proportion of injuries were 1610(66.64%)with spinal fracture or dislocation of spine,386(15.98%)with thoracic and back trauma,and 194(8.03%)with craniocerebral trauma,respectively.In this study,surgical treatment and conservative treatment accounted for 80.64% and 19.36% of the total population,respectively.Only 126 of the patients were operated on the day they were admitted to the hospital,accounting for a ratio of6.45%,290(14.84%),393(20.11%)and 322(16.48%)patients were operated on the second,third and fourth day of admission respectively.From 2013 to 2018,the average of hospitalization days were decreased with times changing gradually,from18.44 ±14.17 days(between June 1,2013 and May 31,2014)to 12.72 ±10.43 days(between June 1,2017 and May 31,2018).The difference was statistically significant(P=0.000,P<0.05).The average cost of hospitalization of all patients was73937.41±57991.83 yuan,the average cost of surgical treatment was 85637.64±55036.04 yuan and that of conservative treatment was 19714.90 ±36600.02 yuan.There was a significant difference in hospital expenses between different years(P=0.000,P<0.05).?Conclusion?At present,most of epidemiological studies on spinal cord injury in China are limited to some hospitals and local areas.With the development of society,the number of patients with spinal cord injury increases year by year,aomog which the propotion of middle-aged and elderly people increases gradually year by year.This study showed that high fall was the main cause of injury,followed by low falls and car accidents.Among all patients with spinal cord injury,cervical spinal cord injury was the highest and incomplete quadriplegia was the most common.The time from injury to admission is significantly shortened with the decrease in the number of referrals.but the implementation of early decompression surgery still low.The days of hospitalization decreased gradually,but the cost of hospitalization was still a great burden to the patients and families with spinal cord injury.The results of this study can provide a theoretical basis for the prevention and treatment of spinal cord injury and the allocation of medical resources. |
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