Clinical Analyses of Traumatic Cervical Spinal Cord Injury Patients Treated in the Intensive Care Unit

J. Han, Se-Hoon Kim, J. Choi, Sung-Kon Ha, Sang-Dae Kim, D. Lim, Bum-Joon Kim
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Abstract

Objective: Patients with spinal cord injury (SCI) are often unstable and require intensive care unit (ICU) treatment in the acute phase. This study assists in the prognosis and treatment direction of SCI patients by retrospectively examining and analyzing the clinical characteristics of SCI patients admitted to the ICU.Methods: In this study, a total of 102 SCI patients were admitted to the ICU of our hospital from February 2013 to March 2019. Based on the medical records, the patient's gender, age, mechanism of injuries, day of hospitalization, surgery timing, tracheostomy, ventilator use, steroid use, underlying disease, and hypotension were investigated. To assess the clinical outcome, the american spinal injury association (ASIA) impairment scale and limb motor grade three weeks and six months after injury was evaluated.Results: Of the 102 patients, 76 (74.51%) were male, and the average age was 57.57 years. Of these, 87 (85.29%) had spinal surgery, while 30 (34.48%) had surgery within 36 h after injury. High doses of steroids were administered in 15 patients (14.85%). As for the ASIA impairment scale, Grade A at the initial stage of injury reached 15% of all patients but decreased to 5.1% after three weeks and 1.9% after six months.Conclusion: Early surgery was advantageous in improving the lower extremity motor grade at three weeks of injury. Although steroid use has no significant effect compared to the risk of complications in several previous studies, in this study, it was observed that the ASIA scale improved six months after injury in patients receiving high-dose steroids.
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重症监护室外伤性颈脊髓损伤的临床分析
目的:脊髓损伤(SCI)患者往往不稳定,在急性期需要重症监护病房(ICU)治疗。本研究通过对ICU收治的SCI患者的临床特征进行回顾性分析,为脊髓损伤患者的预后和治疗方向提供帮助。方法:本研究选取2013年2月至2019年3月我院ICU收治的102例SCI患者。根据病历,调查患者的性别、年龄、损伤机制、住院天数、手术时间、气管切开术、呼吸机使用、类固醇使用、基础疾病和低血压。为了评估临床结果,对损伤后3周和6个月的美国脊髓损伤协会(ASIA)损伤量表和肢体运动等级进行评估。结果:102例患者中,男性76例(74.51%),平均年龄57.57岁。其中87例(85.29%)行脊柱手术,30例(34.48%)在损伤后36 h内行手术。15例患者(14.85%)使用高剂量类固醇。ASIA损伤量表中,损伤初期A级占所有患者的15%,3周后降至5.1%,6个月后降至1.9%。结论:早期手术有利于改善损伤后3周的下肢运动等级。虽然在之前的几项研究中,类固醇的使用对并发症的风险没有显著影响,但在本研究中,我们观察到接受大剂量类固醇的患者在受伤后6个月的ASIA评分有所改善。
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