Analysis of clinical characteristics and risk factors of long-term death in patients with acute severe cervical spinal cord injury

English Keywords:Spinal cord injury  Cervical spinal cord injury  Clinical characteristics  Binary logistic regression analysis

English Abstract:

  【Abstract】 Objectives: To summarize the clinical characteristics of patients with severe traumatic cervical spinal cord injury, and to analyze the predictive factors that may affect their long-term death, and to provide reference for preventive treatment. Methods: The clinical characteristics of 207 patients with severe cervical spinal cord injury admitted to our hospital from January 1, 2010 to May 31, 2018 were retrospectively analyzed. Demographic characteristics, injury factors, injury characteristics(injury factors, responsibility gaps, AIS grades, combined injuries, etc.), hospitalization and complications, and post-injury death were analyzed. Results: Male and female ratio was 7.63∶1. The average age was 44.72±13.73 years. High energy injury was the main cause of injury (including high fall, car accident, heavy body injury and other combined injuries) (159 cases, 76.8%). In 134 cases(64.73%) of the patients under the age of 50, the injured segments were C1-C2(3 cases, 1.4%), C3(28 cases, 13.5%), C4-C5(124, 58%), C6(25 cases, 12.1%), C7(26 cases, 12.6%), C8(5 cases, 2.4%). All the patients were injured for 3.6±3.5 days and 16.2±16.9 days after admission， and the respiratory system failure (63 cases 30.4%) and water electrolyte disorder (25, 12.1%) were the main complications during the hospitalization. The total mortality was 30.91%(64 cases) in 8 years. Binary logistic regression analysis showed that the age over 50 years old, the C1-C4 injury, the conservative treatment, the ventilator dependence were the risk factors of long-term death(P<0.05). Conclusions: Severe traumatic cervical spinal cord injury is common in young and middle-aged male patients. The injury site occurs in the C4 and C5 segments, mainly due to high-energy violent trauma; advanced age, upper cervical spine injury, no surgical decompression and combined respiratory dysfunction are easy to cause long-term death of the patient.