The changing demographics of traumatic spinal cord injury: An 11-year study of 831 patients

Thompson, Cynthia; Mutch, Jennifer; Parent, Stefan; Mac-Thiong, Jean-Marc

doi:10.1179/2045772314y.0000000233

Cited by 101 publications

(81 citation statements)

References 20 publications

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“…17 Katoh et al 11 reported that the percentage of geriatric patients had increased during the study period. Thompson et al 6 also found the median age was 44.8 years in his research, higher than others' reports. 6 So it may be explained for increasing ageing of the general population in China.…”

Section: Discussioncontrasting

confidence: 41%

“…Thompson et al 6 also found the median age was 44.8 years in his research, higher than others' reports. 6 So it may be explained for increasing ageing of the general population in China. What's more, the reason for 35-55-year age group was the most vulnerable may be due to the matter that they were the major social productivity, exposing them to high-risk environments.…”

Section: Discussioncontrasting

confidence: 41%

“…With the conditions mentioned above, older individuals might be less likely to accept active treatments when facing severe complications as they did not want to waste money and increase financial burden on their families. 6 In our survey, 116 patients (32.8%) received conservative treatment, and 204 patients (57.6%) received surgical treatment, and the others (34 patients, 9.6%) left hospital against medical advice. The majority of patients chose to accept a surgery for trying to improve their life conditions.…”

Section: Discussionmentioning

confidence: 99%

“…Nijendijk et al 5 reported incidence of TSCI surviving the acute phase to be 11.7 per million per annum in 2010 in the Netherlands. Thompson et al 6 reported that incidence of TSCI varied between 10.6 and 22.6 per million per year in Québec, Canada (2000)(2001)(2002)(2003)(2004)(2005)(2006)(2007)(2008)(2009)(2010)(2011). Also, other countries reported the incidence of acute traumatic SCI as 10.2 per million for Denmark (1990Denmark ( -2012 7 , 13 per million for Botswana (2011-2013), 8 25.1-38.1 per million for Finland (2012)(2013) 9 and 21.0-32.3 per million for Australia .…”

Section: Introductionmentioning

confidence: 99%

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Traumatic spinal cord injury in Tianjin, China: a single-center report of 354 cases

et al. 2015

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were reviewed. Collected variables included gender, age, marital status, ethnic group, occupation, etiology, neurological level of injury, American Spinal Injury Association (ASIA)-ISCoS impairment scale at admission, the severity, death and its cause, concomitant injuries and treatment choice. Results: During the study period, 354 cases were identified. Male-to-female ratio was 2.34:1, with a mean age of 50.1 ± 15.5 years. Falls (55.1%), comprising low falls and high falls (33.6% and 21.5%, respectively), were the leading cause, followed by motor vehicle collisions (MVCs) (35.9%). The most common injury site was the cervical spinal cord, especially C4-C6, accounting for 59.3%. Surgery was the major treatment choice (57.6%). Conclusion: The number of TSCI patients increased annually in our center. The mean age at the time of injury was older, and the proportion of males was higher. The leading two causes were falls and MVCs. The SCIs caused by MVCs were increasing. Peasants, workers and unemployed individuals were those at higher risk. Surgery was the major treatment choice. These data may be useful to implement those preventive strategies focused on the characteristics of different groups and pay more attention to high-risk populations.

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Section: Discussioncontrasting

confidence: 41%

Section: Discussioncontrasting

confidence: 41%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Traumatic spinal cord injury in Tianjin, China: a single-center report of 354 cases

et al. 2015

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“…Similar trends have been recently reported in the Canadian population. 39 Although a demographic subgroup analysis was not performed, no notable differences in patterns of transverse intramedullary T2 signal hyperintensity among age group or injury mechanisms were observed. However, to validate the BA-SIC score, future studies including larger patient populations across geographic regions are warranted.…”

Section: Discussionmentioning

confidence: 99%

The Brain and Spinal Injury Center score: a novel, simple, and reproducible method for assessing the severity of acute cervical spinal cord injury with axial T2-weighted MRI findings

Talbott

Whetstone²,

Readdy

et al. 2015

SPI

137

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OBJECT Previous studies that have evaluated the prognostic value of abnormal changes in signals on T2-weighted MRI scans of an injured spinal cord have focused on the longitudinal extent of this signal abnormality in the sagittal plane. Although the transverse extent of injury and the degree of spared spinal cord white matter have been shown to be important for predicting outcomes in preclinical animal models of spinal cord injury (SCI), surprisingly little is known about the prognostic value of altered T2 relaxivity in humans in the axial plane. METHODS The authors undertook a retrospective chart review of 60 patients who met the inclusion criteria of this study and presented to the authors’ Level I trauma center with an acute blunt traumatic cervical SCI. Within 48 hours of admission, all patients underwent MRI examination, which included axial and sagittal T2 images. Neurological symptoms, evaluated with the grades according to the American Spinal Injury Association (ASIA) Impairment Scale (AIS), at the time of admission and at hospital discharge were correlated with MRI findings. Five distinct patterns of intramedullary spinal cord T2 signal abnormality were defined in the axial plane at the injury epicenter. These patterns were assigned ordinal values ranging from 0 to 4, referred to as the Brain and Spinal Injury Center (BASIC) scores, which encompassed the spectrum of SCI severity. RESULTS The BASIC score strongly correlated with neurological symptoms at the time of both hospital admission and discharge. It also distinguished patients initially presenting with complete injury who improved by at least one AIS grade by the time of discharge from those whose injury did not improve. The authors’ proposed score was rapid to apply and showed excellent interrater reliability. CONCLUSIONS The authors describe a novel 5-point ordinal MRI score for classifying acute SCIs on the basis of axial T2-weighted imaging. The proposed BASIC score stratifies the SCIs according to the extent of transverse T2 signal abnormality during the acute phase of the injury. The new score improves on current MRI-based prognostic descriptions for SCI by reflecting functionally and anatomically significant patterns of intramedullary T2 signal abnormality in the axial plane.

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Early vs Late Surgical Decompression for Central Cord Syndrome

et al. 2022

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ImportanceThe optimal clinical management of central cord syndrome (CCS) remains unclear; yet this is becoming an increasingly relevant public health problem in the face of an aging population.ObjectiveTo provide a head-to-head comparison of the neurologic and functional outcomes of early (&lt;24 hours) vs late (≥24 hours) surgical decompression for CCS.Design, Setting, and ParticipantsPatients who underwent surgery for CCS (lower extremity motor score [LEMS] − upper extremity motor score [UEMS] ≥ 5) were included in this propensity score–matched cohort study. Data were collected from December 1991 to March 2017, and the analysis was performed from March 2020 to January 2021. This study identified patients with CCS from 3 international multicenter studies with data on the timing of surgical decompression in spinal cord injury. Participants were included if they had a documented baseline neurologic examination performed within 14 days of injury. Participants were eligible if they underwent surgical decompression for CCS.ExposuresEarly surgery was compared with late surgery.Main Outcomes and MeasuresPropensity scores were calculated as the probability of undergoing early compared with late surgery using the logit method and adjusting for relevant confounders. Propensity score matching was performed in a 1:1 ratio by an optimal-matching technique. The primary end point was motor recovery (UEMS, LEMS, American Spinal Injury Association [ASIA] motor score [AMS]) at 1 year. Secondary end points were Functional Independence Measure (FIM) motor score and complete independence in each FIM motor domain at 1 year.ResultsThe final study cohort consisted of 186 patients with CCS. The early-surgery group included 93 patients (mean [SD] age, 47.8 [16.8] years; 66 male [71.0%]), and the late-surgery group included 93 patients (mean [SD] age, 48.0 [15.5] years; 75 male [80.6%]). Early surgical decompression resulted in significantly improved recovery in upper limb (mean difference [MD], 2.3; 95% CI, 0-4.5; P = .047), but not lower limb (MD, 1.1; 95% CI, −0.8 to 3.0; P = .30), motor function. In an a priori–planned subgroup analysis, outcomes were comparable with early or late decompressive surgery in patients with ASIA Impairment Scale (AIS) grade D injury. However, in patients with AIS grade C injury, early surgery resulted in significantly greater recovery in overall motor score (MD, 9.5; 95% CI, 0.5-18.4; P = .04), owing to gains in both upper and lower limb motor function.Conclusions and RelevanceThis cohort study found early surgical decompression to be associated with improved recovery in upper limb motor function at 1 year in patients with CCS. Treatment paradigms for CCS should be redefined to encompass early surgical decompression as a neuroprotective therapy.

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The changing demographics of traumatic spinal cord injury: An 11-year study of 831 patients

Cited by 101 publications

References 20 publications

Traumatic spinal cord injury in Tianjin, China: a single-center report of 354 cases

Traumatic spinal cord injury in Tianjin, China: a single-center report of 354 cases

The Brain and Spinal Injury Center score: a novel, simple, and reproducible method for assessing the severity of acute cervical spinal cord injury with axial T2-weighted MRI findings

Early vs Late Surgical Decompression for Central Cord Syndrome

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