scholarly journals Does spinal cord injury influence the mortality rate in patients with necrotizing fasciitis?

Spinal Cord ◽  
2011 ◽  
Vol 50 (4) ◽  
pp. 338-340 ◽  
Author(s):  
M Citak ◽  
T Fehmer ◽  
M Backhaus ◽  
J Hauser ◽  
R Meindl ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Mortality Rate ◽  
Necrotizing Fasciitis ◽  
Cord Injury

Curative-intent resection for bronchogenic carcinoma in patients with prior spinal cord injury: The Department of Veterans Affairs experience

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 17127-17127
Author(s):  
L. S. Brunworth ◽  
D. Dharmasena ◽  
K. S. Virgo ◽  
F. E. Johnson
Keyword(s):  
Lung Cancer ◽  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Mortality Rate ◽  
Bronchogenic Carcinoma ◽  
Veterans Affairs ◽  
Department Of Veterans Affairs ◽  
Curative Intent ◽  
Cord Injury ◽  
Morbid Conditions

17127 Background: There are approximately 250,000 people with spinal cord injury (SCI) in the US, and they have a high prevalence of smoking. A literature search yielded no published information concerning the clinical course of SCI patients who subsequently develop bronchogenic carcinoma and undergo pulmonary resection for this condition. We hypothesized that poorer outcomes of surgery would be observed in this population, as compared to neurally-intact patients. Methods: We conducted a study of all veterans at Department of Veterans Affairs (DVA) Medical Centers during fiscal years 1993–2002 who were diagnosed with SCI, subsequently developed non-small cell lung cancer and were then surgically treated with curative intent. Inclusion criteria included American Spinal Injury Association type A injury (complete loss of neural function distal to the injury site) and traumatic etiology. Data were compiled from national DVA datasets and supplemented by operative reports, pathology reports, progress notes, and discharge summaries. Results: Of 12,634 patients who underwent surgery for bronchogenic carcinoma, 55 also had codes for prior SCI; 7 were evaluable. The mean age was 64. Five (71%) had one or more co-morbid conditions in addition to their spinal cord injuries. All 7 underwent pulmonary lobectomy. Post-operative complications occurred in 4 patients (57%). Two patients died post-operatively on days 29 and 499, yielding a 30-day mortality rate of 14% and an in-hospital mortality rate of 29%. Conclusions: We believe this isthe only report in the English language literature on this topic. SCI patients with resectable bronchogenic carcinoma have a high incidence of co-morbid conditions. Those who undergo curative-intent surgery have high morbidity and mortality rates. This evidence suggests that SCI should be considered a risk factor for adverse outcomes of surgery for primary lung cancer, strengthening the case for alternative treatments. No significant financial relationships to disclose.

scholarly journals Survival among patients with severe high cervical spine injuries – a TraumaRegister DGU® database study

2021 ◽  
Vol 29 (1) ◽  
Author(s):  
O. Kamp ◽  
◽  
O. Jansen ◽  
R. Lefering ◽  
M. Aach ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Mortality Rate ◽  
Prediction Models ◽  
Cervical Spinal Cord ◽  
Cervical Spinal Cord Injury ◽  
Actual Mortality ◽  
Cord Injury ◽  
High Cervical ◽  
Trauma Scores

Abstract Background Trauma is a significant cause of death and impairment. The Abbreviated Injury Scale (AIS) differentiates the severity of trauma and is the basis for different trauma scores and prediction models. While the majority of patients do not survive injuries which are coded with an AIS 6, there are several patients with a severe high cervical spinal cord injury that could be discharged from hospital despite the prognosis of trauma scores. We estimate that the trauma scores and prediction models miscalculate these injuries. For this reason, we evaluated these findings in a larger control group. Methods In a retrospective, multi-centre study, we used the data recorded in the TraumaRegister DGU® (TR-DGU) to select patients with a severe cervical spinal cord injury and an AIS of 3 to 6 between 2002 to 2015. We compared the estimated mortality rate according to the Revised Injury Severity Classification II (RISC II) score against the actual mortality rate for this group. Results Six hundred and twelve patients (0.6%) sustained a severe cervical spinal cord injury with an AIS of 6. The mean age was 57.8 ± 21.8 years and 441 (72.3%) were male. 580 (98.6%) suffered a blunt trauma, 301 patients were injured in a car accident and 29 through attempted suicide. Out of the 612 patients, 391 (63.9%) died from their injury and 170 during the first 24 h. The group had a predicted mortality rate of 81.4%, but we observed an actual mortality rate of 63.9%. Conclusions An AIS of 6 with a complete cord syndrome above C3 as documented in the TR-DGU is survivable if patients get to the hospital alive, at which point they show a survival rate of more than 35%. Compared to the mortality prognosis based on the RISC II score, they survived much more often than expected.

scholarly journals Spinal cord injury: epidemiologycal study of 386 cases with emphasis on those patients admitted more than four hours after the trauma

2008 ◽  
Vol 66 (2b) ◽  
pp. 365-368 ◽  
Author(s):  
Manoel Baldoino Leal-Filho ◽  
Guilherme Borges ◽  
Bruno Ribeiro de Almeida ◽  
Aline de Almeida Xavier Aguiar ◽  
Marcelo Adriano da Cunha e Silva Vieira ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Mortality Rate ◽  
Health Service ◽  
Risk Of Death ◽  
Clinical Complications ◽  
Cord Injury ◽  
Specialized Care ◽  
Multiple Levels

We studied 386 cases of spinal cord injury to analyze the follow up of the patients admitted most of the time more than four hours, the majority of the injuries happening far from the attending health service and first specialized care received long after the accident. This is a clinical study based on data collected during hospitalization of the patients, operated or not, in a Brazilian public health service. The lesion mainly seen was fracture and dislocation, isolated or on multiple levels, and the most important clinical complications were due to respiratory failure and hypotension, especially because 73.8% were from outside and they were admitted more then four hours after the trauma. The mortality rate was 11.9%, but just 2.1% had undergone a surgery. The complications resulted in major risk of death when the trauma was at the cervical level and the patients were over 50 years old, especially when admitted more than four hours after the trauma. We emphasize the importance of the first health care concerning the clinical treatment, aiming to reduce the mortality rate.

scholarly journals Cervical Spine AIS 6 – untreatable but survivable

2020 ◽  
Author(s):  
Oliver Kamp ◽  
O. Jansen ◽  
R. Lefering ◽  
M. Aach ◽  
C. Waydhas ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Mortality Rate ◽  
Cervical Spinal Cord ◽  
Cervical Spinal Cord Injury ◽  
Control Group ◽  
Multi Centre Study ◽  
Actual Mortality ◽  
Cord Injury ◽  
Trauma Scores

Abstract Background Trauma is a significant cause of death and impairment. The Abbreviated Injury Scale (AIS) differentiates the severity of trauma and is the basis for different trauma scores and prediction models. An AIS of 6 is described as currently untreatable or unsurvivable. While the majority of patients do not survive such injuries, there are several patients with a cervical spinal cord injury and an AIS of 6 that could be discharged from hospital despite the prognosis of trauma scores. For this reason, we evaluated these findings in a larger control group. Methods In a retrospective, multi-centre study, we used the data recorded in the TraumaRegister DGU® (TR-DGU) to select patients with a severe cervical spinal cord injury and an AIS of 3 to 6 between 2002 to 2015. We compared the estimated mortality rate according to the Revised Injury Severity Classification II (RISC II) score against the actual mortality rate for this group. Results Six hundred and twelve patients (0.6%) sustained a severe cervical spinal cord injury with an AIS of 6. The mean age was 57.8 ± 21.8 years and 441 (72.3%) were male. 580 (98.6%) suffered a blunt trauma, 301 patients were injured in a car accident and 29 through attempted suicide. Out of the 612 patients, 391 (63.9%) died from their injury and 170 during the first 24 hours. The group had a predicted mortality rate of 81.4%, but we observed an actual mortality rate of 63.9%. Conclusions An AIS of 6 with a complete cord syndrome above C3 as documented in the TR-DGU is survivable if patients get to the hospital alive, at which point they show a survival rate of more than 35%. Compared to the mortality predictive model of the RISC II score, they survived much more often than expected.

Patients with thoracic trauma and concomitant spinal cord injury have a markedly decreased mortality rate compared to patients without spinal cord injury

2015 ◽  
Vol 40 (1) ◽  
pp. 155-159 ◽  
Author(s):  
Maren Bertling ◽  
Eduardo Suero ◽  
Mirko Aach ◽  
Thomas Schildhauer ◽  
Renate Meindl ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Mortality Rate ◽  
Thoracic Trauma ◽  
Cord Injury

scholarly journals Survival among patients with severe high cervical spine injuries – A TraumaRegister DGU®  database study

2020 ◽  
Author(s):  
Oliver Kamp ◽  
O. Jansen ◽  
R. Lefering ◽  
M. Aach ◽  
C. Waydhas ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Mortality Rate ◽  
Prediction Models ◽  
Cervical Spinal Cord ◽  
Cervical Spinal Cord Injury ◽  
Actual Mortality ◽  
Cord Injury ◽  
High Cervical ◽  
Trauma Scores

Abstract BackgroundTrauma is a significant cause of death and impairment. The Abbreviated Injury Scale (AIS) differentiates the severity of trauma and is the basis for different trauma scores and prediction models. While the majority of patients do not survive injuries which are coded with an AIS 6, there are several patients with a severe high cervical spinal cord injury that could be discharged from hospital despite the prognosis of trauma scores. We estimate that the trauma scores and prediction models miscalculate these injuries. For this reason, we evaluated these findings in a larger control group.MethodsIn a retrospective, multi-centre study, we used the data recorded in the TraumaRegister DGU® (TR-DGU) to select patients with a severe cervical spinal cord injury and an AIS of 3 to 6 between 2002 to 2015. We compared the estimated mortality rate according to the Revised Injury Severity Classification II (RISC II) score against the actual mortality rate for this group.ResultsSix hundred and twelve patients (0.6%) sustained a severe cervical spinal cord injury with an AIS of 6. The mean age was 57.8 ± 21.8 years and 441 (72.3%) were male. 580 (98.6%) suffered a blunt trauma, 301 patients were injured in a car accident and 29 through attempted suicide. Out of the 612 patients, 391 (63.9%) died from their injury and 170 during the first 24 hours. The group had a predicted mortality rate of 81.4%, but we observed an actual mortality rate of 63.9%.ConclusionsAn AIS of 6 with a complete cord syndrome above C3 as documented in the TR-DGU is survivable if patients get to the hospital alive, at which point they show a survival rate of more than 35%. Compared to the mortality prognosis based on the RISC II score, they survived much more often than expected.

scholarly journals Mortality Rate and Predicting Factors of Traumatic Thoracolumbar Spinal Cord Injury; A Systematic Review and Meta-Analysis

2018 ◽  
Vol 6 (3) ◽  
pp. 181-194 ◽  
Author(s):  
Amir Azarhomayun ◽  
Maryam Aghasi ◽  
Najmeh Mousavi ◽  
Farhad Shokraneh ◽  
Alexander R. Vaccaro ◽  
...  
Keyword(s):  
Systematic Review ◽  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Mortality Rate ◽  
Meta Analysis ◽  
Predicting Factors ◽  
Cord Injury

Review Paper: Epidemiology of Traumatic Spinal Cord Injury: Comparisons Between Developed and Developing Countries

2009 ◽  
Vol 22 (1) ◽  
pp. 9-18 ◽  
Author(s):  
Wen-Ta Chiu ◽  
Hsiao-Chiao Lin ◽  
Carlos Lam ◽  
Shu-Fen Chu ◽  
Yung-Hsiao Chiang ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Developing Countries ◽  
Mortality Rate ◽  
Traffic Accidents ◽  
Developed Countries ◽  
Incidence Rates ◽  
Traumatic Spinal Cord Injury ◽  
Severity Of Injury ◽  
Cord Injury

A review of global epidemiological studies of traumatic spinal cord injury (TSCI) within 2 decades was undertaken to compare the incidence, mortality rate, patients’ age, gender, causes, and severity of injury between developed countries and developing countries. The incidence rates varied greatly, and there was also a 2-fold difference between the highest mortality rate in developing countries and that in developed countries. Male sex and age from 30 to 50 years are strong risk factors in both these groups. Traffic accidents are the leading cause of injury in developed countries, whereas falls are the leading cause in developing countries. To clarify regional differences, future studies should contain long-term data about TSCI characteristics in a region-based population.

scholarly journals Decrease of PPARδin Type-1-Like Diabetic Rat for Higher Mortality after Spinal Cord Injury

PPAR Research ◽  
2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
Cheng-Chia Tsai ◽  
Kung-Shing Lee ◽  
Sheng-Hsien Chen ◽  
Li-Jen Chen ◽  
Keng-Fan Liu ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Mortality Rate ◽  
Survival Rates ◽  
Diabetic Rats ◽  
Diabetic Rat ◽  
Peroxisome Proliferator ◽  
Survival Times ◽  
Cord Injury ◽  
Peroxisome Proliferator Activated Receptors

Changes in the peroxisome proliferator-activated receptors-δ(PPARδ) expression in rats after spinal cord injury (SCI) have been previously reported. Diabetic animals show a higher mortality after SCI. However, the relationship between the progress of diabetes and PPARδin SCI remains unknown. In the present study, we used compressive SCI in streptozotocin-(STZ-) induced diabetic rats. GW0742, a PPARδagonist, was used to evaluate its merit in STZ rats after SCI. Changes in PPARδexpression were detected by Western blot. Survival rates were also estimated. A lower expression of PPARδin spinal cords of STZ-diabetic rats was observed. In addition, the survival times in two-week induction diabetes were longer than those in eight-week induction group, which is consistent with the expression of PPARδin the spinal cord. Moreover, GW0742 significantly increased the survival time of STZ rats. Furthermore, their motor function and pain response were attenuated by GSK0660, a selective PPARδantagonist, but were enhanced by GW0742. In conclusion, the data suggest that higher mortality rate in STZ-diabetic rats with SCI is associated with the decrease of PPARδexpression. Thus, change of PPARδexpression with the progress of diabetes seems responsible for the higher mortality rate after SCI.

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