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沙特阿拉伯创伤性脊柱骨折后成人的神经功能障碍:一项回顾性单中心病历审查。

Neurological disability among adults following traumatic spinal fractures in Saudi Arabia: a retrospective single-center medical record review.

作者信息

AlEissa Sami, AlAssiri Suhail Saad, AlJehani Rayed Meshal, Konbaz Faisal Mohammedsaleh, AlSalman Mohammed Jassim, Abaalkhail Majed, AlShehri Mohammed Hassan, Alfaris Ibrahim, Alghnam Suliman Abdulah

机构信息

Dr. Suhail Saad AlAssiri, Department of Orthopedic Surgery,, National Guard Hospital,, King Abdulaziz Medical City,, Riyadh 11662, Saudi Arabia, T: +9966563456700, suhailasiri@ gmail.com, ORCID: http://orcid. org/0000-0001-7119-1201.

出版信息

Ann Saudi Med. 2019 Jan-Feb;39(1):8-12. doi: 10.5144/0256-4947.2019.8.

Abstract

BACKGROUND

A traumatic spinal fracture (TSF) is a serious condition that has a tremendous impact on patients and their families. Understanding the causes and patterns of TSF is critical in developing prevention programs.

OBJECTIVES

Identify causes and patterns of TSF and explore predictors of neurological disability in Saudi Arabia.

DESIGN

A retrospective medical record review.

SETTING

Level 1 trauma center in Riyadh.

PATIENTS AND METHODS

The analysis included all consecutive patients who met the inclusion criteria for any acute TSF in patients 18 years of age and older from January 2001 to January 2016. A multivariate logistic regression model was used to identify predictors of neurological disability following TSF.

MAIN OUTCOME MEASURES

Neurological disability in patients sustaining TSF.

SAMPLE SIZE

1128 patients.

RESULTS

Of 1128 patients, 971 patients (86%) were male with a mean (SD) age 34.4 (16.6) years. The most common mechanism of injury was motor vehicle accidents (88.4%). Cervical spine was the most commonly affected region (48%, n=468) with a mortality rate of 7.6%. Neurological disability occurred in 74 (6.7%) patients, and 41 (8.7%) of those with cervical fractures died in the hospital. The Injury Severity Score was a significant predictor of neurological disability following TSF.

CONCLUSION

A high proportion of neurological disability following TSF was found. Further studies should attempt to improve the docu.mentation rate of seatbelt status in all traumatic cases including mild injuries. This data will increase our understanding of adult TSF and possibly facilitate injury prevention strategies.

LIMITATIONS

Single hospital and may not be generalizable.

CONFLICT OF INTEREST

None.

摘要

背景

创伤性脊柱骨折(TSF)是一种严重的病症,对患者及其家庭产生巨大影响。了解TSF的病因和模式对于制定预防计划至关重要。

目的

确定沙特阿拉伯TSF的病因和模式,并探索神经功能障碍的预测因素。

设计

回顾性病历审查。

地点

利雅得的一级创伤中心。

患者和方法

分析纳入了2001年1月至2016年1月期间所有符合18岁及以上急性TSF纳入标准的连续患者。采用多因素逻辑回归模型确定TSF后神经功能障碍的预测因素。

主要观察指标

发生TSF患者的神经功能障碍。

样本量

1128例患者。

结果

1128例患者中,971例(86%)为男性,平均(标准差)年龄34.4(16.6)岁。最常见 的损伤机制是机动车事故(88.4%)。颈椎是最常受累的部位(48%,n = 468),死亡率为7.6%。74例(6.7%)患者出现神经功能障碍,其中41例(8.7%)颈椎骨折患者在医院死亡。损伤严重程度评分是TSF后神经功能障碍的重要预测因素。

结论

发现TSF后神经功能障碍的比例较高。进一步的研究应尝试提高所有创伤病例(包括轻度损伤)中安全带使用情况的记录率。这些数据将增加我们对成人TSF的了解,并可能促进损伤预防策略的制定。

局限性

单中心研究,可能不具有普遍性。

利益冲突

无。

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