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Spinal cord injury: epidemiologycal study of 386 cases with emphasis on those patients admitted more than four hours after the trauma
We studied 386 cases of spinal cord injury to analyze the follow up of the patients admitted most of the time more than four hours, the majority of the injuries happening far from the attending health service and first specialized care received long after the accident. This is a clinical study based...
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Published in: | Arquivos de neuro-psiquiatria 2008-06, Vol.66 (2b), p.365-368 |
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creator | Leal-Filho, Manoel Baldoino Borges, Guilherme Almeida, Bruno Ribeiro de Aguiar, Aline de Almeida Xavier Vieira, Marcelo Adriano da Cunha e Silva Dantas, Karoline da Silva Morais, Ricardo Keyson Paiva de Santos, Carlos Rogério Nogueira dos Mendes, Sumihara de Sousa Pinheiro, Luciana Maria |
description | We studied 386 cases of spinal cord injury to analyze the follow up of the patients admitted most of the time more than four hours, the majority of the injuries happening far from the attending health service and first specialized care received long after the accident. This is a clinical study based on data collected during hospitalization of the patients, operated or not, in a Brazilian public health service. The lesion mainly seen was fracture and dislocation, isolated or on multiple levels, and the most important clinical complications were due to respiratory failure and hypotension, especially because 73.8% were from outside and they were admitted more then four hours after the trauma. The mortality rate was 11.9%, but just 2.1% had undergone a surgery. The complications resulted in major risk of death when the trauma was at the cervical level and the patients were over 50 years old, especially when admitted more than four hours after the trauma. We emphasize the importance of the first health care concerning the clinical treatment, aiming to reduce the mortality rate.
Estudamos 386 casos de trauma raquimedular, observando a evolução dos pacientes admitidos na maioria das vezes após quatro horas do trauma, a maioria procedente de lugar distante do serviço de saúde. Trata-se de um estudo clínico baseado em dados coletados durante a hospitalização, de pacientes operados ou não, em serviço de saúde pública no Brasil. Na maioria das vezes a lesão principal foi fratura-luxação, isolada ou em múltiplos níveis, e as complicações clínicas mais importantes foram devido à insuficiência respiratória e hipotensão, especialmente porque 73.8% dos casos eram de lugares distantes, tendo sido admitidos mais de quatro horas após o trauma. A taxa de mortalidade foi 11,9%, sendo 2,1% em pós-operatório. As complicações resultaram em maior risco de morte quando o trauma foi ao nível cervical, idade acima de 50 anos, especialmente aqueles admitidos com mais de quatro horas. Enfatizamos a importância do primeiro atendimento na admissão, sobretudo para as alterações respiratórias e hemodinâmicas, objetivando reduzir a mortalidade. |
doi_str_mv | 10.1590/S0004-282X2008000300016 |
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Estudamos 386 casos de trauma raquimedular, observando a evolução dos pacientes admitidos na maioria das vezes após quatro horas do trauma, a maioria procedente de lugar distante do serviço de saúde. Trata-se de um estudo clínico baseado em dados coletados durante a hospitalização, de pacientes operados ou não, em serviço de saúde pública no Brasil. Na maioria das vezes a lesão principal foi fratura-luxação, isolada ou em múltiplos níveis, e as complicações clínicas mais importantes foram devido à insuficiência respiratória e hipotensão, especialmente porque 73.8% dos casos eram de lugares distantes, tendo sido admitidos mais de quatro horas após o trauma. A taxa de mortalidade foi 11,9%, sendo 2,1% em pós-operatório. As complicações resultaram em maior risco de morte quando o trauma foi ao nível cervical, idade acima de 50 anos, especialmente aqueles admitidos com mais de quatro horas. Enfatizamos a importância do primeiro atendimento na admissão, sobretudo para as alterações respiratórias e hemodinâmicas, objetivando reduzir a mortalidade.</description><identifier>ISSN: 0004-282X</identifier><identifier>ISSN: 1678-4227</identifier><identifier>EISSN: 0004-282X</identifier><identifier>DOI: 10.1590/S0004-282X2008000300016</identifier><language>eng</language><publisher>Academia Brasileira de Neurologia - ABNEURO</publisher><subject>NEUROSCIENCES ; PSYCHIATRY</subject><ispartof>Arquivos de neuro-psiquiatria, 2008-06, Vol.66 (2b), p.365-368</ispartof><rights>This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c376t-455906ba27ffbe485d844aa3f3a9afff70fb73f68fba02818a16e392bc0b5d383</citedby><cites>FETCH-LOGICAL-c376t-455906ba27ffbe485d844aa3f3a9afff70fb73f68fba02818a16e392bc0b5d383</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,780,784,885,24150,27924,27925</link.rule.ids></links><search><creatorcontrib>Leal-Filho, Manoel Baldoino</creatorcontrib><creatorcontrib>Borges, Guilherme</creatorcontrib><creatorcontrib>Almeida, Bruno Ribeiro de</creatorcontrib><creatorcontrib>Aguiar, Aline de Almeida Xavier</creatorcontrib><creatorcontrib>Vieira, Marcelo Adriano da Cunha e Silva</creatorcontrib><creatorcontrib>Dantas, Karoline da Silva</creatorcontrib><creatorcontrib>Morais, Ricardo Keyson Paiva de</creatorcontrib><creatorcontrib>Santos, Carlos Rogério Nogueira dos</creatorcontrib><creatorcontrib>Mendes, Sumihara de Sousa</creatorcontrib><creatorcontrib>Pinheiro, Luciana Maria</creatorcontrib><title>Spinal cord injury: epidemiologycal study of 386 cases with emphasis on those patients admitted more than four hours after the trauma</title><title>Arquivos de neuro-psiquiatria</title><addtitle>Arq. Neuro-Psiquiatr</addtitle><description>We studied 386 cases of spinal cord injury to analyze the follow up of the patients admitted most of the time more than four hours, the majority of the injuries happening far from the attending health service and first specialized care received long after the accident. This is a clinical study based on data collected during hospitalization of the patients, operated or not, in a Brazilian public health service. The lesion mainly seen was fracture and dislocation, isolated or on multiple levels, and the most important clinical complications were due to respiratory failure and hypotension, especially because 73.8% were from outside and they were admitted more then four hours after the trauma. The mortality rate was 11.9%, but just 2.1% had undergone a surgery. The complications resulted in major risk of death when the trauma was at the cervical level and the patients were over 50 years old, especially when admitted more than four hours after the trauma. We emphasize the importance of the first health care concerning the clinical treatment, aiming to reduce the mortality rate.
Estudamos 386 casos de trauma raquimedular, observando a evolução dos pacientes admitidos na maioria das vezes após quatro horas do trauma, a maioria procedente de lugar distante do serviço de saúde. Trata-se de um estudo clínico baseado em dados coletados durante a hospitalização, de pacientes operados ou não, em serviço de saúde pública no Brasil. Na maioria das vezes a lesão principal foi fratura-luxação, isolada ou em múltiplos níveis, e as complicações clínicas mais importantes foram devido à insuficiência respiratória e hipotensão, especialmente porque 73.8% dos casos eram de lugares distantes, tendo sido admitidos mais de quatro horas após o trauma. A taxa de mortalidade foi 11,9%, sendo 2,1% em pós-operatório. As complicações resultaram em maior risco de morte quando o trauma foi ao nível cervical, idade acima de 50 anos, especialmente aqueles admitidos com mais de quatro horas. Enfatizamos a importância do primeiro atendimento na admissão, sobretudo para as alterações respiratórias e hemodinâmicas, objetivando reduzir a mortalidade.</description><subject>NEUROSCIENCES</subject><subject>PSYCHIATRY</subject><issn>0004-282X</issn><issn>1678-4227</issn><issn>0004-282X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2008</creationdate><recordtype>article</recordtype><recordid>eNp1kc1OwzAMgCsEEmPwDOTEbSNNujblhib-pEkcBhK3ym0dlqltSpwK9QF4bzKGEBLiECf2Z8d_UXQe83m8yPnlmnOezIQSL4JzFRQZTpweRJMfcPjrfRydEG05F0meZ5PoY92bDhpWWVcz020HN14x7E2NrbGNfR2rAMkP9cisZlKlrAJCYu_Gbxi2_QbIELMd8xtLyHrwBjtPDOrWeI81a63DAKFj2g6ObYIIVHt0wRqIg6GF0-hIQ0N49n1Po-fbm6fl_Wz1ePewvF7NKpmlfpYsQsNpCSLTusRELWqVJABSS8hBa51xXWZSp0qXwIWKFcQpylyUFS8XtVRyGs33_1JlsLHFNlQTuqfia4jFnyGGgIt9QO_s24Dki9ZQhU0DHdqBCsHjWAi1c8z2jpWzRA510TvTghuLmBe7Pf2b4hO1zYY4</recordid><startdate>20080601</startdate><enddate>20080601</enddate><creator>Leal-Filho, Manoel Baldoino</creator><creator>Borges, Guilherme</creator><creator>Almeida, Bruno Ribeiro de</creator><creator>Aguiar, Aline de Almeida Xavier</creator><creator>Vieira, Marcelo Adriano da Cunha e Silva</creator><creator>Dantas, Karoline da Silva</creator><creator>Morais, Ricardo Keyson Paiva de</creator><creator>Santos, Carlos Rogério Nogueira dos</creator><creator>Mendes, Sumihara de Sousa</creator><creator>Pinheiro, Luciana Maria</creator><general>Academia Brasileira de Neurologia - ABNEURO</general><scope>AAYXX</scope><scope>CITATION</scope><scope>7TK</scope><scope>GPN</scope></search><sort><creationdate>20080601</creationdate><title>Spinal cord injury: epidemiologycal study of 386 cases with emphasis on those patients admitted more than four hours after the trauma</title><author>Leal-Filho, Manoel Baldoino ; Borges, Guilherme ; Almeida, Bruno Ribeiro de ; Aguiar, Aline de Almeida Xavier ; Vieira, Marcelo Adriano da Cunha e Silva ; Dantas, Karoline da Silva ; Morais, Ricardo Keyson Paiva de ; Santos, Carlos Rogério Nogueira dos ; Mendes, Sumihara de Sousa ; Pinheiro, Luciana Maria</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c376t-455906ba27ffbe485d844aa3f3a9afff70fb73f68fba02818a16e392bc0b5d383</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2008</creationdate><topic>NEUROSCIENCES</topic><topic>PSYCHIATRY</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Leal-Filho, Manoel Baldoino</creatorcontrib><creatorcontrib>Borges, Guilherme</creatorcontrib><creatorcontrib>Almeida, Bruno Ribeiro de</creatorcontrib><creatorcontrib>Aguiar, Aline de Almeida Xavier</creatorcontrib><creatorcontrib>Vieira, Marcelo Adriano da Cunha e Silva</creatorcontrib><creatorcontrib>Dantas, Karoline da Silva</creatorcontrib><creatorcontrib>Morais, Ricardo Keyson Paiva de</creatorcontrib><creatorcontrib>Santos, Carlos Rogério Nogueira dos</creatorcontrib><creatorcontrib>Mendes, Sumihara de Sousa</creatorcontrib><creatorcontrib>Pinheiro, Luciana Maria</creatorcontrib><collection>CrossRef</collection><collection>Neurosciences Abstracts</collection><collection>SciELO</collection><jtitle>Arquivos de neuro-psiquiatria</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Leal-Filho, Manoel Baldoino</au><au>Borges, Guilherme</au><au>Almeida, Bruno Ribeiro de</au><au>Aguiar, Aline de Almeida Xavier</au><au>Vieira, Marcelo Adriano da Cunha e Silva</au><au>Dantas, Karoline da Silva</au><au>Morais, Ricardo Keyson Paiva de</au><au>Santos, Carlos Rogério Nogueira dos</au><au>Mendes, Sumihara de Sousa</au><au>Pinheiro, Luciana Maria</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Spinal cord injury: epidemiologycal study of 386 cases with emphasis on those patients admitted more than four hours after the trauma</atitle><jtitle>Arquivos de neuro-psiquiatria</jtitle><addtitle>Arq. Neuro-Psiquiatr</addtitle><date>2008-06-01</date><risdate>2008</risdate><volume>66</volume><issue>2b</issue><spage>365</spage><epage>368</epage><pages>365-368</pages><issn>0004-282X</issn><issn>1678-4227</issn><eissn>0004-282X</eissn><abstract>We studied 386 cases of spinal cord injury to analyze the follow up of the patients admitted most of the time more than four hours, the majority of the injuries happening far from the attending health service and first specialized care received long after the accident. This is a clinical study based on data collected during hospitalization of the patients, operated or not, in a Brazilian public health service. The lesion mainly seen was fracture and dislocation, isolated or on multiple levels, and the most important clinical complications were due to respiratory failure and hypotension, especially because 73.8% were from outside and they were admitted more then four hours after the trauma. The mortality rate was 11.9%, but just 2.1% had undergone a surgery. The complications resulted in major risk of death when the trauma was at the cervical level and the patients were over 50 years old, especially when admitted more than four hours after the trauma. We emphasize the importance of the first health care concerning the clinical treatment, aiming to reduce the mortality rate.
Estudamos 386 casos de trauma raquimedular, observando a evolução dos pacientes admitidos na maioria das vezes após quatro horas do trauma, a maioria procedente de lugar distante do serviço de saúde. Trata-se de um estudo clínico baseado em dados coletados durante a hospitalização, de pacientes operados ou não, em serviço de saúde pública no Brasil. Na maioria das vezes a lesão principal foi fratura-luxação, isolada ou em múltiplos níveis, e as complicações clínicas mais importantes foram devido à insuficiência respiratória e hipotensão, especialmente porque 73.8% dos casos eram de lugares distantes, tendo sido admitidos mais de quatro horas após o trauma. A taxa de mortalidade foi 11,9%, sendo 2,1% em pós-operatório. As complicações resultaram em maior risco de morte quando o trauma foi ao nível cervical, idade acima de 50 anos, especialmente aqueles admitidos com mais de quatro horas. Enfatizamos a importância do primeiro atendimento na admissão, sobretudo para as alterações respiratórias e hemodinâmicas, objetivando reduzir a mortalidade.</abstract><pub>Academia Brasileira de Neurologia - ABNEURO</pub><doi>10.1590/S0004-282X2008000300016</doi><tpages>4</tpages><oa>free_for_read</oa></addata></record> |
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title | Spinal cord injury: epidemiologycal study of 386 cases with emphasis on those patients admitted more than four hours after the trauma |
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