Complications and Mortality After Acute Traumatic Spinal Cord Injury
Traumatic spinal cord injury (SCI), which occurs when a blunt force permanently damages the spinal cord, is a common cause of death and disability worldwide. Individuals who survive the initial injury typically go on to develop significant complications in the weeks or months following the injury, including loss of respiratory function, loss of bladder control, loss of motor function, or paralysis. Unfortunately, many patients do not survive these secondary complications; despite recent advances in emergency and rehabilitative medicine, the mortality rate remains high during the first year after an SCI.
To develop interventions and treatments that improve mortality after SCI, researchers need to understand the current prevalence and risk factors associated with SCI-related mortality. A team of researchers advanced this effort by studying complications during the early rehabilitation phase of SCI recovery among patients living in Saint Petersburg, a large city in western Russia. The team collected medical records from 311 SCI patients who were admitted to Saint Petersburg hospitals between 2012 and 2016. They reviewed each patient’s characteristics, complications, cause of death, and length-of-stay in the hospital, finding that:
- One-third of patients experienced complications as a direct result of their SCI. The most common complications were loss of respiratory function and development of pressure ulcers (or bedsores).
- Patients who sustained traumatic brain injury (TBI) and SCI at the same time were more likely to experience complications.
- In all cases, patients with complications had increased length-of-stay and were more likely to die. Within the first three weeks of injury, 15% of patients died.
- Mortality was more likely among patients who were older, had more severe injuries, experienced respiratory complications, or were intoxicated at the time of injury.
The researchers recommended that clinicians could decrease early mortality among SCI patients by focusing on prevention and reduction of complications in the days following injury. They also pointed out a need for educational campaigns to increase awareness of the potential risks associated with drug and alcohol consumption.
Mirzaeva L, Lobzin S, Tcinzerling N, et al. Complications and mortality after acute traumatic spinal cord injury in Saint Petersburg, Russia. Spinal Cord. (April 2020).