Respiratory morbidity and mortality of traumatic cervical spinal cord injury at a level I trauma center in India
Study design Descriptive retrospective. Objectives To evaluate the burden of respiratory morbidity in terms of ventilator dependence (VD) days and length of stay in neurotrauma ICU (NICU) and hospital, and to determine mortality in patients with traumatic cervical spinal cord injury (CSCI) in a low...
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| Veröffentlicht in: | Spinal cord series and cases Jg. 7; H. 1; S. 36 |
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13.05.2021
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| Abstract | Study design
Descriptive retrospective.
Objectives
To evaluate the burden of respiratory morbidity in terms of ventilator dependence (VD) days and length of stay in neurotrauma ICU (NICU) and hospital, and to determine mortality in patients with traumatic cervical spinal cord injury (CSCI) in a low middle-income country (LMIC).
Setting
Jai Prakash Narayan Apex Trauma Center (JPNATC), All India Institute of Medical Sciences (AIIMS), New Delhi, India.
Methods
A total of 135 patients admitted with CSCI in the NICU between January 2017 to December 2018 were screened. Information regarding age, gender, American Spinal Injury Association (ASIA) impairment scale (AIS), level of injury, duration of VD, length of NICU, hospital stay, and outcome in terms of mortality or discharge from the hospital were obtained from the medical records.
Results
A total of 106 CSCI patients were analyzed. The mean (SD) age of patients was 40 (±16) years and male: female ratio was 5:1. The duration of VD, duration of NICU, and hospital stay was a median of 8 days (IQR 1127), 6 days (IQR 1118), and 15 days (IQR 3127) respectively. Mortality was 19% (20/106). The mortality was significantly associated with poorer AIS score, VD, and duration of ICU and hospital stay. All patients were discharged to home only after they became ventilator-free.
Conclusions
The ventilator burden, hospital stay, and mortality are high in patients with CSCI in LMICs. Poor AIS scores, prolonged VD, ICU and hospital stay are associated with mortality. There is a need for comprehensive CSCI rehabilitation programs in LMICs to improve outcome. |
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| AbstractList | Study designDescriptive retrospective.ObjectivesTo evaluate the burden of respiratory morbidity in terms of ventilator dependence (VD) days and length of stay in neurotrauma ICU (NICU) and hospital, and to determine mortality in patients with traumatic cervical spinal cord injury (CSCI) in a low middle-income country (LMIC).SettingJai Prakash Narayan Apex Trauma Center (JPNATC), All India Institute of Medical Sciences (AIIMS), New Delhi, India.MethodsA total of 135 patients admitted with CSCI in the NICU between January 2017 to December 2018 were screened. Information regarding age, gender, American Spinal Injury Association (ASIA) impairment scale (AIS), level of injury, duration of VD, length of NICU, hospital stay, and outcome in terms of mortality or discharge from the hospital were obtained from the medical records.ResultsA total of 106 CSCI patients were analyzed. The mean (SD) age of patients was 40 (±16) years and male: female ratio was 5:1. The duration of VD, duration of NICU, and hospital stay was a median of 8 days (IQR 1127), 6 days (IQR 1118), and 15 days (IQR 3127) respectively. Mortality was 19% (20/106). The mortality was significantly associated with poorer AIS score, VD, and duration of ICU and hospital stay. All patients were discharged to home only after they became ventilator-free.ConclusionsThe ventilator burden, hospital stay, and mortality are high in patients with CSCI in LMICs. Poor AIS scores, prolonged VD, ICU and hospital stay are associated with mortality. There is a need for comprehensive CSCI rehabilitation programs in LMICs to improve outcome. Descriptive retrospective. To evaluate the burden of respiratory morbidity in terms of ventilator dependence (VD) days and length of stay in neurotrauma ICU (NICU) and hospital, and to determine mortality in patients with traumatic cervical spinal cord injury (CSCI) in a low middle-income country (LMIC). Jai Prakash Narayan Apex Trauma Center (JPNATC), All India Institute of Medical Sciences (AIIMS), New Delhi, India. A total of 135 patients admitted with CSCI in the NICU between January 2017 to December 2018 were screened. Information regarding age, gender, American Spinal Injury Association (ASIA) impairment scale (AIS), level of injury, duration of VD, length of NICU, hospital stay, and outcome in terms of mortality or discharge from the hospital were obtained from the medical records. A total of 106 CSCI patients were analyzed. The mean (SD) age of patients was 40 (±16) years and male: female ratio was 5:1. The duration of VD, duration of NICU, and hospital stay was a median of 8 days (IQR 1127), 6 days (IQR 1118), and 15 days (IQR 3127) respectively. Mortality was 19% (20/106). The mortality was significantly associated with poorer AIS score, VD, and duration of ICU and hospital stay. All patients were discharged to home only after they became ventilator-free. The ventilator burden, hospital stay, and mortality are high in patients with CSCI in LMICs. Poor AIS scores, prolonged VD, ICU and hospital stay are associated with mortality. There is a need for comprehensive CSCI rehabilitation programs in LMICs to improve outcome. Descriptive retrospective.STUDY DESIGNDescriptive retrospective.To evaluate the burden of respiratory morbidity in terms of ventilator dependence (VD) days and length of stay in neurotrauma ICU (NICU) and hospital, and to determine mortality in patients with traumatic cervical spinal cord injury (CSCI) in a low middle-income country (LMIC).OBJECTIVESTo evaluate the burden of respiratory morbidity in terms of ventilator dependence (VD) days and length of stay in neurotrauma ICU (NICU) and hospital, and to determine mortality in patients with traumatic cervical spinal cord injury (CSCI) in a low middle-income country (LMIC).Jai Prakash Narayan Apex Trauma Center (JPNATC), All India Institute of Medical Sciences (AIIMS), New Delhi, India.SETTINGJai Prakash Narayan Apex Trauma Center (JPNATC), All India Institute of Medical Sciences (AIIMS), New Delhi, India.A total of 135 patients admitted with CSCI in the NICU between January 2017 to December 2018 were screened. Information regarding age, gender, American Spinal Injury Association (ASIA) impairment scale (AIS), level of injury, duration of VD, length of NICU, hospital stay, and outcome in terms of mortality or discharge from the hospital were obtained from the medical records.METHODSA total of 135 patients admitted with CSCI in the NICU between January 2017 to December 2018 were screened. Information regarding age, gender, American Spinal Injury Association (ASIA) impairment scale (AIS), level of injury, duration of VD, length of NICU, hospital stay, and outcome in terms of mortality or discharge from the hospital were obtained from the medical records.A total of 106 CSCI patients were analyzed. The mean (SD) age of patients was 40 (±16) years and male: female ratio was 5:1. The duration of VD, duration of NICU, and hospital stay was a median of 8 days (IQR 1127), 6 days (IQR 1118), and 15 days (IQR 3127) respectively. Mortality was 19% (20/106). The mortality was significantly associated with poorer AIS score, VD, and duration of ICU and hospital stay. All patients were discharged to home only after they became ventilator-free.RESULTSA total of 106 CSCI patients were analyzed. The mean (SD) age of patients was 40 (±16) years and male: female ratio was 5:1. The duration of VD, duration of NICU, and hospital stay was a median of 8 days (IQR 1127), 6 days (IQR 1118), and 15 days (IQR 3127) respectively. Mortality was 19% (20/106). The mortality was significantly associated with poorer AIS score, VD, and duration of ICU and hospital stay. All patients were discharged to home only after they became ventilator-free.The ventilator burden, hospital stay, and mortality are high in patients with CSCI in LMICs. Poor AIS scores, prolonged VD, ICU and hospital stay are associated with mortality. There is a need for comprehensive CSCI rehabilitation programs in LMICs to improve outcome.CONCLUSIONSThe ventilator burden, hospital stay, and mortality are high in patients with CSCI in LMICs. Poor AIS scores, prolonged VD, ICU and hospital stay are associated with mortality. There is a need for comprehensive CSCI rehabilitation programs in LMICs to improve outcome. Study design Descriptive retrospective. Objectives To evaluate the burden of respiratory morbidity in terms of ventilator dependence (VD) days and length of stay in neurotrauma ICU (NICU) and hospital, and to determine mortality in patients with traumatic cervical spinal cord injury (CSCI) in a low middle-income country (LMIC). Setting Jai Prakash Narayan Apex Trauma Center (JPNATC), All India Institute of Medical Sciences (AIIMS), New Delhi, India. Methods A total of 135 patients admitted with CSCI in the NICU between January 2017 to December 2018 were screened. Information regarding age, gender, American Spinal Injury Association (ASIA) impairment scale (AIS), level of injury, duration of VD, length of NICU, hospital stay, and outcome in terms of mortality or discharge from the hospital were obtained from the medical records. Results A total of 106 CSCI patients were analyzed. The mean (SD) age of patients was 40 (±16) years and male: female ratio was 5:1. The duration of VD, duration of NICU, and hospital stay was a median of 8 days (IQR 1127), 6 days (IQR 1118), and 15 days (IQR 3127) respectively. Mortality was 19% (20/106). The mortality was significantly associated with poorer AIS score, VD, and duration of ICU and hospital stay. All patients were discharged to home only after they became ventilator-free. Conclusions The ventilator burden, hospital stay, and mortality are high in patients with CSCI in LMICs. Poor AIS scores, prolonged VD, ICU and hospital stay are associated with mortality. There is a need for comprehensive CSCI rehabilitation programs in LMICs to improve outcome. |
| ArticleNumber | 36 |
| Author | Goyal, Keshav Sengupta, Deep Mishra, Ashwani Kumar Singh, Pankaj Kumar Bindra, Ashish Kumar, Niraj Chaturvedi, Arvind Malhotra, Rajesh |
| Author_xml | – sequence: 1 givenname: Deep orcidid: 0000-0002-5183-9223 surname: Sengupta fullname: Sengupta, Deep organization: Neuroanaesthesiology and Critical Care, Jai Prakash Narayan Apex Trauma Center, All India Institute of Medical Sciences – sequence: 2 givenname: Ashish surname: Bindra fullname: Bindra, Ashish email: dr_ashi2208@yahoo.com organization: Neuroanaesthesiology and Critical Care, Jai Prakash Narayan Apex Trauma Center, All India Institute of Medical Sciences – sequence: 3 givenname: Niraj surname: Kumar fullname: Kumar, Niraj organization: Neuroanaesthesiology and Critical Care, Jai Prakash Narayan Apex Trauma Center, All India Institute of Medical Sciences – sequence: 4 givenname: Keshav orcidid: 0000-0001-9139-0689 surname: Goyal fullname: Goyal, Keshav organization: Neuroanaesthesiology and Critical Care, Jai Prakash Narayan Apex Trauma Center, All India Institute of Medical Sciences – sequence: 5 givenname: Pankaj Kumar surname: Singh fullname: Singh, Pankaj Kumar organization: Neurosurgey, Jai Prakash Narayan Apex Trauma Center, All India Institute of Medical Sciences – sequence: 6 givenname: Arvind surname: Chaturvedi fullname: Chaturvedi, Arvind organization: Neuroanaesthesiology and Critical Care, Jai Prakash Narayan Apex Trauma Center, All India Institute of Medical Sciences – sequence: 7 givenname: Rajesh surname: Malhotra fullname: Malhotra, Rajesh organization: Jai Prakash Narayan Apex Trauma Center, All India Institute of Medical Sciences – sequence: 8 givenname: Ashwani Kumar surname: Mishra fullname: Mishra, Ashwani Kumar organization: Biostatistics, National Drug Dependence Treatment Center, All India Institute of Medical Sciences |
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| Cites_doi | 10.1097/MRR.0b013e3282fb7d25 10.1038/sc.2017.102 10.4102/ajod.v3i2.80 10.1179/2045772311Y.0000000024 10.1080/10790268.2006.11753901. 10.1038/sc.2017.10 10.1179/2045772314Y.0000000254 10.1038/s41393-020-0421-y 10.2340/16501977-2323 10.4103/JETS.JETS_132_17 10.1183/20734735.012616 10.2106/JBJS.G.00637 10.1016/j.anclin.2018.09.009 10.1177/2151459318770882 10.1038/s41393-017-0055-x 10.1038/s41393-019-0286-0 10.1016/j.wneu.2015.12.097 10.1097/brs.0000000000003302 10.1097/OI9.0000000000000003 10.1038/sc.2015.8 10.1007/s00268-012-1459-6 10.1155/2013/168757 10.1097/01.brs.0000207258.80129.03 10.1177/2192568217694362 10.5935/0103-507X.20150006 10.1089/neu.2009.1151 10.4103/1673-5374.274332 10.1159/000382079 |
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To evaluate the burden of respiratory morbidity in terms of ventilator dependence (VD) days and length of... Descriptive retrospective. To evaluate the burden of respiratory morbidity in terms of ventilator dependence (VD) days and length of stay in neurotrauma ICU... Study designDescriptive retrospective.ObjectivesTo evaluate the burden of respiratory morbidity in terms of ventilator dependence (VD) days and length of stay... Descriptive retrospective.STUDY DESIGNDescriptive retrospective.To evaluate the burden of respiratory morbidity in terms of ventilator dependence (VD) days and... |
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| Title | Respiratory morbidity and mortality of traumatic cervical spinal cord injury at a level I trauma center in India |
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