Initial factors predicting survival in patients with a spinal cord injury.

Abstract

SUMMARY A study is presented of a prospective analysis of survival rates in 157 patients with spinal cord injury consecutively admitted to the Pellegrin Hospital (University Hospital, Bordeaux, FrBnce). There was a 20% death rate, occurring in the first three months after injury. Three independent predictors ofsurvival in patients with spinal cord injuries (age, initial conscious level and respiratory assistance) were found by analysis of the course of the disorder. ResultsThe total sample consisted of 157 patients, 82% were males, with a male/female ratio of 4 to 1. During the first month of follow up, six subjects were lost while another five were lost in the following 6 months. The subjects ranged in ages from 5 to 86 years (mean age = 38 years), 42% of the subjects being over 40 years. A peak was found in the range of 20 to 40 years. Within this population 52% were tetraplegic patients, 40% were injured at the C4-C5-C6 level. Among the paraplegic patients (48% ofthe population) the lesions were mainly found at the T3-T4 (I1 %) and T1 1-T12 (13%) levels. 403

Life Expectancy After Spinal Cord Injury In a Developing Country-A Retrospective Study At CRP, Bangladesh.

“…It was found that the majority of persons were paraplegic rather than tetraplegic (79.75% vs 20.25%), which is different from findings in other studies. In France, 52% were found to be tetraplegic, and 48% paraplegic (Daverat et al, 1989); a study in Pakistan showed that 47.2% were tetraplegic and 52.8% paraplegic (Zubia et al, 2008). This difference in finding may be due to the higher mortality of persons with cervical cord injury as a result of different causes of injury in other countries, improper evacuation from injury sites, careless transportation to hospital, inadequate acute management and lack of pre-hospital care.…”

High dose methylprednisolone in the management of acute spinal cord injury – a systematic review from a clinical perspective

“…Concern about lack of information on the risk side is underlined by the fact that randomised controlled trials, of necessity, involve selected populations. Comparison between NASCIS 2 morbidity 1,17 and the model system outcomes 11 in America and the study of Petitjean 22 with the paper on survival 13 from the same hospital some years previously serve to substantiate this concern. The pro®le of potential steroid related side eects and causes of mortality/ morbidity in acute spinal cord injury overlap, making their detection dicult.…”

“…13 Injury severity scoring systems can be correlated with early mortality risk. 14 The initial extent of spinal cord dysfunction is the main predictor for neurological outcome. 12,15 ± 17 The pattern of neurological improvement is related to both the level at which the cord is damaged and completeness of the de®cit.…”

Initial factors predicting functional performance in patients with traumatic tetraplegia

“…Lesion level still remained insignificant. It could be explained by a selection bias: tetraplegic patients who died had the highest lesions (Daverat et al , 1989). …”