[与中枢脊髓综合征患者致死相关的危险因素]。

Patricio Dabdoub-González, Edgar Abel Márquez-García, Juan Gerardo Reyes-García, Jorge Arturo Cabrera-Escamilla, David Fernando Servín-Carmona, Víctor Hugo Tejerina-Gorena, Cristóbal Herrera-Palacios, Elvia Janike Rodríguez-Córdoba
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摘要

背景:中枢脊髓综合征是最常见的不完全性脊髓损伤,占成人脊髓损伤的9%。目的:确定与中心脊髓综合征(CCS)患者的致死率或/和机械通气(MV)相关的危险因素。材料和方法:在创伤后CCS患者的回顾性队列中,我们在急诊入院时和出院前进行了评估。因变量为死亡或MV。我们计算了发病率、相对风险(RR)(CI95%),并通过风险系数模型对证明风险倾向的变量进行了统计显著变量关联的多变量模型。结果:在101例CCS患者中,85.1%的患者患有严重髓管狭窄,9.9%的患者需要MV;死亡率为13.9%。与死亡相关的唯一危险因素是MV的使用,RR为3.6(CI95%1.4-9.5);有MV倾向的风险大于60 RR 5.4(CI95%0.6-44.2)。其他因素显示有死亡倾向,但无统计学意义。结论:MV是一个与死亡率相关的危险因素,其他因素证实了死亡率的趋势;60岁以上,高血压,糖尿病,椎管狭窄,住院20天以上,并在事故发生后10天以上接受干预。我们样本中的死亡率高于此前在其他国际文章中报道的死亡率。了解和识别这些和其他因素将使我们能够识别并发症风险更大的患者。
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[Risk factors associated with lethality on patients with central cord syndrome].

Background: Central Cord Syndrome is the most common incomplete spinal cord injury, and it represents 9% of all spinal injuries of the adult.

Objective: to determine the risk factors associated with lethality or/and mechanical ventilation (MV) in patients with Central Cord Syndrome (CCS).

Material and methods: upon a retrospective cohort with patients with posttraumatic CCS we evaluated at the time of emergency admission and until the hospital discharge. The dependent variable was dead or MV. We calculated incidence, relative risk (RR) with CI95% and a multivariate model for the association of statistically significant variables by means of a risk coefficient model upon the variables that evidenciated tendencies towards risk.

Results: From 101 patients with CCS, 85.1% with a severe medullary canal stenosis and 9.9% required MV; the mortality was 13.9%. The only risk factor associated with dead was the use of MV with an RR of 3.6 (CI95% 1.4-9.5); the risk with tendencies towards MV was being older than 60 RR 5.4 (CI95% 0.6-44.2). Other factors demonstrated a tendency towards mortality, but they were not statistically significant.

Conclusions: MV is a risk factor associated with mortality, other factors evidenciated tendencies towards mortality; being older than 60, hypertension, diabetes mellitus, narrow spinal canal, more than 20 days of hospital stay and being intervened farther than 10 days from the accident. The incidence of mortality in our sample is greater than thus reported previously on other international articles. To know and identify these and other factors will let us identify patients with a greater risk of complications.

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