Outcome of Surgical and Intensive Care Treatment of Patients with Traumatic Cervical Spinal Cord Injury: A Single Center, Cross-Sectional, Retrospective Study
1Akdeniz University, Department of Neurosurgery, Antalya, Turkey
2Akdeniz University, Department of Internal Medicine ICU Unit, Antalya, Turkey
3Akdeniz University, Department of Anesthesia and Reanimation, Antalya, Turkey
J Crit Intensive Care 2023; 14(3): 89-95 DOI: 10.37678/dcybd.2023.3479
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Aim: In this study, we aimed to evaluate the surgical process, anesthesia management and intensive care follow-up of patients with traumatic cervical spinal cord injury (TCSCI) admitted to the Intensive Care Unit (ICU) and to determine the factors affecting patient outcomes.
Study Design and Methods: This study was carried out as a single-center, cross-sectional, retrospective study. Surgically treated patients with TCSCI were retrospectively evaluated in terms of age, sex, etiology of trauma, fracture side, Glasgow coma scale (GCS), Acute Physiology and Chronic Health Evaluation II score (APACHE II), neurological outcome, mechanical ventilation requirement, inotropic therapy requirement, nosocomial infections, ICU length of stay, ward length of stay and ICU mortality.
Results: A total of 41 patients were included in the study. There were 10 (24.39%) female patients in our study and the median age was 48(33.5–66.0) years. The most common cause of trauma was fall from height in 14 patients (34.14%), followed by traffic accidents in 12 patients (29.26%). The most common involvement was C7 fracture in 7 (17.07%) patients and C4-C5 listhesis in 8 (19.52%) patients. Fourteen (34.14%) of the patients underwent 360-degree stabilization (both anterior and posterior), 24 (58.53%) underwent only anterior stabilization, and 3 (7.31%) underwent only posterior stabilization and the median APACHE II score was 10.16 (4–26). The median duration of ICU stay was 2 (1.0–5.5) days. The mortality rate was 12.9%; it was 36.4% in patients with neurologic deficits and 3.3% in patients without neurologic deficits (p=0.014)
Conclusions: Surgical approach, anesthesia management and intensive care management are complementary for TCSCI patients. The severity of the neurological deficit has a direct effect on the survival of the patients.