Traumatic spinal cord injury in Victoria, 2007–2016

Beck, Ben; Cameron, Peter; Braaf, Sandra; Nunn, Andrew; Fitzgerald, Mark; Judson, Rodney; Teague, Warwick J.; Lennox, Alyse; Middleton, James; Harrison, James Edward; Gabbe, Belinda

doi:10.5694/mja2.50143

Cited by 29 publications

(19 citation statements)

References 24 publications

(27 reference statements)

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“…Similar to the findings in the US [ 40 ] and Australia [ 2 ], falls were the most important external cause for SCI mortality in all age groups, especially in the elderly. Motor vehicle crashes were an important cause of SCI death in the 24-65-year age group, which might be explained by the 8.5year increase in life expectancy during the past two decades and the greater proportion of elderly people living with chronic diseases at risk of fall related injuries and death [ 41 ].…”

Section: Discussionsupporting

confidence: 85%

“…Traumatic brain injury (TBI) and spinal cord injury (SCI) are injuries of the brain and spinal cord, leading to the functional alteration or pathological changes [ 1 , 2 ]. Both the TBI and SCI are significant global public health issues which contribute to the excessive health-care and economic burden because of the loss of productivity and increased health-care costs [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

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Trends and external causes of traumatic brain injury and spinal cord injury mortality in south China, 2014–2018: an ecological study

Zheng

Qian

et al. 2021

BMC Public Health

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Background The epidemiological evidence of traumatic brain injury (TBI) and spinal cord injury (SCI) mortality in mainland China is lacking. We aimed to assess the trends of TBI and SCI mortality, and their association with sex, age, location and external causes of injury in south China. Methods Mortality data were derived from the Disease Surveillance Points (DSPs) system of Guangdong province between 2014 and 2018. We examined the trends in mortality with Cochran–Armitage trend test, and the association between the socio-demographic factors and the TBI and SCI mortality by using negative binomial models. Subgroup analysis was performed by stratifying the external causes of TBI and SCI. Results The age-standardized TBI mortality remained relatively stable (from 11.6 to 15.4 per 100,000), while the SCI mortality increased by 148.3% from 2014 to 2018. Compared with females and urban residents, the adjusted mortality rate ratios of males and rural residents were 2.3 and 2.0 for TBI, and 2.2 and 4.6 for SCI, respectively. TBI and SCI mortality increased substantially with age. Motor vehicle crashes and falls were the leading causes of TBI mortality in residents aged under 75 years and over 75 years, respectively. Falls were the most important external cause for SCI death of all ages. Conclusions Being male, rural and elderly residents are at higher risk of dying from TBI and SCI. The substantial burden of TBI and SCI caused by road traffic crashes and falls has called for the urgent need to improve injury prevention, pre-hospital aid, hospital treatment and recovery.

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Section: Discussionsupporting

confidence: 85%

Section: Introductionmentioning

confidence: 99%

Trends and external causes of traumatic brain injury and spinal cord injury mortality in south China, 2014–2018: an ecological study

Zheng

Qian

et al. 2021

BMC Public Health

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“…In this present study, in-hospital and six-month mortality were 21.84% and 11.76%, respectively, compared to reported mortalities for patients with cervical cord injuries of 4.0-28%. 6,13 Advanced age, a higher level of injury, cause of SCI, late surgery against early surgery, and presence of respiratory failure on admission have been suggested as contributing factors 6,16 whereas in this study multivariate analysis showed the level of injury and respiratory failure as the only independent predictors of in-hospital mortality. 4,13 There are some explanations about the impact of a higher level of injury on mortality-patients with a higher level of cervical cord injury are generally accompanied by a higher rate of respiratory failure, more severe neurological dysfunction, and a higher risk of pulmonary complications such as pneumonia.…”

Section: Discussioncontrasting

confidence: 48%

Acute traumatic quadriplegia: Predictors of in-hospital and six-month mortality

Alimohammadi

Ahadi

Rezaee

et al. 2020

Trauma

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Background Traumatic spinal cord injury is one of the most disastrous and devastating health burdens all over the world with a high mortality rate. The present study aimed to evaluate the predictors of in-hospital and six-month mortality in these patients. Methods The electronic medical records of 87 consecutive patients with acute complete traumatic quadriplegia were reviewed to extract clinical, radiological, and laboratory data. Simple and multiple logistic regression models were used to estimate crude and adjusted odds with 95% confidence interval (CI) ratios for the predictors of in-hospital mortality and six-month mortality. Results There were 48 males and the mean age was 38.67 ± 12.81; in-hospital and six-month mortality were 21.84% and 11.76%, respectively. Traffic road accidents (67.8%) and falls (12.6%) were the most common causes of injury. The univariate analysis demonstrated advanced age, level of injury, late surgery or no surgical intervention, the lack of methylprednisolone therapy, a higher Charlson comorbidity index, the Injury Severity Score, and the presence of respiratory failure or bradycardia on admission were predictors of in-hospital mortality ( p < 0.05). In the final multiple logistic regression model, the level of injury (OR = 0.02 (0.001,0.35), p = 0.008) and the presence of respiratory failure (OR = 2.37 (0.03,13.88), p = 0.024) were the only predictors of in-hospital mortality. The univariate model showed that the level of injury, respiratory failure on admission, and the Injury Severity Score were the predictors of six-month mortality; however, the level of injury was the only predictor of the six-month mortality (OR = 1.12 (0.99, 1.27), p = 0.028) according to the multiple logistic regression model. Conclusions Several factors could affect in-hospital and six-month mortality in patients with traumatic spinal cord injury. Our findings demonstrated the level of injury and respiratory failure on admission as independent predictors of in-hospital mortality in these patients. Furthermore, the level of injury was the only independent predictor of six-month mortality in the present study.

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“…One possible explanation for this finding is that even within etiology groups, older individuals may have lower-energy injuries than younger individuals. Beck and associates 24 found that SCI caused by low falls were more common in persons age 65 years or older, whereas high falls as a cause of SCI were more common in those younger than 65 years old. In addition, high falls were more likely to result in complete paraplegia compared with low falls (24% vs. 5.2%), which are less likely to convert to incomplete than tetraplegia.…”

Section: Discussionmentioning

confidence: 99%