Valor diagnóstico da tomografia de coluna cervical em vítimas de trauma contuso

Abstract

ABSTRACT ABSTRACT ABSTRACTObjective Objective Objective Objective Objective: to assess the value of computed tomography in the diagnosis of cervical spine and spinal cord injuries in victims of blunt trauma. MethodsMethods Methods Methods Methods: we reviewed the charts of blunt trauma victims from January 2006 to December 2008. We analyzed the following data: epidemiology, mechanism of trauma, transportation of victims to the hospital, intra-hospital care, indication criteria for CT, diagnosis, treatment and evolution of the victims. The victims were divided into two groups: Group I -without cervical spine injury, Group II -with cervical spine injury. Results Results ResultsResults Results: we gathered medical records from 3,101 victims. Computed tomography was performed in 1572 (51%) patients, with male predominance (79%) and mean age of 38.53 years in Group I and 37.60 years in Group II. The distribution of trauma mechanisms was similar in both groups. Lesions found included: 53 fractures, eight vertebral listeses and eight spinal cord injuries. Sequelae included: paraplegia in three cases, quadriplegia in eight and brain injury in five. There were seven deaths in Group II and 240 in Group I. The average length of hospital stay was 11 days for Group I and 26.2 days for Group II. Conclusion Conclusion Conclusion Conclusion Conclusion. A CT scan of the cervical spine in victims of blunt trauma was effective in identifying lesions of the cervical spine and spinal cord injuries. Thus, despite the cost of neck CT and the low incidence of lesions identified by it, its indication based on the usual criteria seems justified. T raumatic injuries account for more than 3.2 million deaths and more than 312 million injured annually worldwide [1][2][3] . In the United States of America (USA) more than 60 million people, mostly aged up to 40 years, are victims of traumatic injuries each year. For every death due to trauma there are 19 hospital admissions, 233 medical consultations and 450 emergencies consultations 1,3,4 . Also in the U.S., 7,800 people annually (32 per million population) suffer spinal cord injuries due to trauma to the spine, the cervical spine representing nearly half (48.7%) of these victims 5 . In Europe,trauma is also the leading cause of death in people up to 40 years of age 3,6 . Thus, trauma has been an increasingly frequent focus of studies and investment in both developed and developing countries 7 .Traumatic injury of the cervical spinal cord is an extremely worrying problem in trauma patient care throughout the world due to the high risk of death and severe sequelae that result in serious permanent limitations, both physical, social and professional. In addition, it causes large health system expenditures, both with prolonged hospitalization and treatment, which usually lasts for years 5,8 . Besides medical treatment, social and economic costs resulting from cervical spinal cord injuries are enormous, as up to 85% of victims who resist the first 24 hours after trauma survive fo...

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