Complications in Patients With Spinal Cord Injuries Sustained in an Earthquake in Northern Pakistan

Tauqir, Syeda Fizza; Mirza, Shirin; Gul, Shahzad; Ghaffar, Hirra; Zafar, Asif

doi:10.1080/10790268.2007.11753955

Cited by 44 publications

(47 citation statements)

References 11 publications

(7 reference statements)

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“…A recent report of complications in a different cohort of 194 SCI earthquake survivors found that only 3 patients (2%) developed DVT, with one dieing of a pulmonary embolism. 21 Although the authors did not report on the use of DVT prophylaxis, it is unlikely, given the circumstances, that many in their sample would have received thromboprophylaxis. There are many similarities in this report with our patients, and together these findings provide further evidence that the prevalence of DVT is low in Southeast Asians, even without thromboprophylaxis.…”

Section: Discussionmentioning

confidence: 98%

The prevalence of deep vein thrombosis in a cohort of patients with spinal cord injury following the Pakistan earthquake of October 2005

et al. 2008

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Study design: Prospective observational study. Objectives: To assess the prevalence of symptomatic deep vein thrombosis (DVT) in earthquake survivors with spinal cord injury (SCI). Settings: Rawalpindi, Pakistan, in the months after the October 2005 earthquake. Methods: Earthquake survivors (n ¼ 187) with acute SCI were enrolled after verbal informed consent. Information on mechanism of injury, mode of evacuation, associated injuries was gathered, and a detailed clinical and radiological assessment was performed. They were followed for 10 weeks for clinical signs and symptoms suggestive of DVT. Case with clinical suspicion of a DVT underwent a duplex scan of both legs to confirm the diagnosis. The influence of age, gender, American Spinal Injury Association (ASIA) grade and lower limb fractures on occurrence of DVT was determined. Results: There were 80 men and 107 women with a mean age of 28.3 ± 12.4 years. Seventeen patients were clinically suspected to have a DVT and ultrasound was positive in nine (4.8%). There was no influence of age (P ¼ 0.4), gender (P ¼ 0.4), ASIA grade (P ¼ 0.1) or presence of a lower limb fracture (P ¼ 0.6) on the occurrence of a DVT. Conclusion: This study adds further evidence to support the belief that the incidence of DVT in Southeast Asian patients with an SCI is lower than the reported incidence in the West. It may not be necessary to apply the recommendations for DVT prophylaxis in Caucasians with SCI to other groups, including Southeast Asians.

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Section: Discussionmentioning

confidence: 98%

The prevalence of deep vein thrombosis in a cohort of patients with spinal cord injury following the Pakistan earthquake of October 2005

et al. 2008

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“…Risk factors for infection include multiple bone fracture, crush syndrome, amputation, and paraplegia (51)(52)(53). Infection was seen in 3 patients in our experience.…”

Section: Infectionmentioning

confidence: 91%

Muskuloskeletal Related Injuries After 2017 Kermanshah Earthquak: A Literature Review

Mortazavi¹,

Ebrahiminasab²,

Farhoud³

et al. 2017

J Orthop Spine Trauma

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Objectives: This study aims to investigate the pattern of Musculoskeletal and soft tissue injuries in a series of referred patients in a tertiary medical center and review previous reports in the literature. Methods: In this study, we recorded musculoskeletal injuries of the victims, following the Kermanshah earthquake on November 12, 2017, with a total number of 38. All patients were admitted to the Imam Khomeini Hospital. Injury type, site of injury, gender, age, complications, mortality, and treatment modality were recorded for each case.Results: Among 38 patients, 18 were male (47%) and 20 were female (53%). The mean age was 37 ± 21.6 years. Most of them were aged between 18 and 65 (71.1%). Lower extremities were involved more than the upper (37% versus 24%) and distal limb involvement was more than the proximal (57.3% versus 43.7%). One patient died due to necrotizing fasciitis and septic shock after femoral shaft open fracture. Two patients developed compartment syndrome and underwent fasciotomy complications by skin necrosis and infection. Conclusions: Soft tissue injuries and fractures are the most common injuries following the earthquakes, hence orthopedic surgeries play a vital role in disasters. Despite patients overload and emergency situation in natural disasters like earthquakes, it is crucial to have a stepwise and evidence based approach for each patient. For the patients with open fractures referred to a tertiary center, careful contamination assessment even in the previously managed wounds is highly recommended, especially for those with early wound closure. Early fasciotomy in the crush syndrome is not beneficial as it has adverse effects such as skin necrosis and infection.

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“…Seven of these papers were excluded either due to lack of epidemiological data on SCI 6,7 or because they cited earlier publications. [8][9][10][11][12] The remaining eight studies [13][14][15][16][17][18][19][20] were analyzed. Three additional papers on SCI following the EQs in China and Haiti [21][22][23] written by the authors (JR, JG) and another paper by Burns 24 were identified by manual search.…”

Section: Methodsmentioning

confidence: 99%

Medical rehabilitation of spinal cord injury following earthquakes in rehabilitation resource-scarce settings: implications for disaster research

et al. 2013

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Study design: Narrative literature review. Objectives: To (1) summarize epidemiological and scientific research on spinal cord injury (SCI) populations from three severe earthquakes (EQs) in rehabilitation resource-scarce settings; (2) summarize SCI rehabilitation services by local and foreign providers in response to these EQs and (3) provide implications including research gaps for a supporting global scientific research agenda. Setting: International. Methods: A literature review was conducted using PubMed to identify epidemiological studies reporting data on SCI survivors of the 2005 Kashmir EQ in Pakistan, the Sichuan EQ of 2008 in China and the 2010 Haiti EQ. A follow-up review on the SCI rehabilitation services provided by local and foreign providers in response to these EQs was also performed. Results: Review of the scientific literature revealed the qualitative trends in focused EQ victim epidemiological data, including SCI classification and types of medical complications. Selected EQ country narratives showed that post-disaster SCI rehabilitation services were expanded by adapting local resources with international assistance to manage the significant numbers of SCI survivors. The resulting SCI research was limited. Conclusion: A global disaster research agenda for SCI in EQs in rehabilitation resource-scarce settings is needed to strengthen the evidence base for improvement of clinical management and outcomes for SCI EQ survivors. Expansion of this limited narrative review into a systematic review to identify additional research gaps is a proposed next step. Effective disaster setting data management and research collaborations of foreign and local SCI disability and rehabilitation stakeholders will be required for agenda implementation.

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Complications in Patients With Spinal Cord Injuries Sustained in an Earthquake in Northern Pakistan

Cited by 44 publications

References 11 publications

The prevalence of deep vein thrombosis in a cohort of patients with spinal cord injury following the Pakistan earthquake of October 2005

The prevalence of deep vein thrombosis in a cohort of patients with spinal cord injury following the Pakistan earthquake of October 2005

Muskuloskeletal Related Injuries After 2017 Kermanshah Earthquak: A Literature Review

Medical rehabilitation of spinal cord injury following earthquakes in rehabilitation resource-scarce settings: implications for disaster research

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