Correlation between demographic characteristics, Spinal Impairment Scale and interventional strategies in clinical outcome of spinal cord injury patients

Background and Aim : The aim of the present study was to investigate the main causes of traumatic spinal cord injury (TSCI) and the relationship between patients’ demographic characteristics and the related treatments.Methods : In this cross-sectional study 608 patients suffering from TSCI referring to Ayatollah Kashani Hospital, Shahrekord in 2016-2017 were enrolled. This research was approved in the form of a research project at Shahrekord University of Medical Sciences with the code of ethics IR.SKUMS.REC.1396.132. Patients demographic characteristics, level of injury, severity of injury (ASIA scale), injury cause, and duration of hospitalization (DOH) by referring to the patient s files and medical records. Several months after discharge, the patients were examined by a neurosurgeon and the treatment outcome was recorded in specific checklists. Data were analyzed by SPSS software and significant level was considered at P<0.05.Results : The mean age of the injured individuals was 34.2 ± 16.9 years. The majority of the injured (70.2%) were male. ASIA grades E and D were also reported in 50.3% and 25% of the injured during hospital admission, respectively. Grade E injury was also observed among 77.1% of the injured during discharge. Drug, non-surgical, and surgical treatments were used for 53.8%, 25.8%, and 20.4% of the patients, respectively. The level of injury, treatment strategy, and clinical outcome were significantly different based on the ASIA grades during admission (P<0.05). There was a significant difference between DOH (day) concerning the level of injury, ASIA grades during admission, and the treatment strategy in different individuals (P<0.05).Conclusion : Regarding the relationship between the treatment strategy, the ASIA grade and the outcome of the treatment, it seems necessary to perform surgical or rehabilitation interventions for each person in accordance with demographic characteristics. Regarding the high prevalence of vertebral column and spinal cord traumas in the province due to traffic accidents, as well as the relationship between the injury level and severity with the treatment outcome, the most important issues that should be addressed in order to reduce irreparable SCIs is as follows: taking preventive measures to reduce road accidents, providing more safety for passengers. It is also necessary to design more precise rules and regulations for work environments and residential facilities to reduce the occurrence of these incidents. Establishment of a TSCI register system would facilitate the provision of a national database for epidemiological and research purposes, which would be useful for advancing the prevention and treatment of TSCI. Promotion of a comprehensive trauma center in all cities and also increasing the number of experts in the trauma centers such as rehabilitation personnel; i.e. occupational therapist, interventional radiologist, nurse, physiotherapist, psychiatrist and so forth.

Keywords:

Trauma , Spinal cord injury , Interventional strategies , ASIA scale