J Neurointensive Care.  2022 Apr;5(1):15-23. 10.32587/jnic.2021.00451.

Clinical Analyses of Traumatic Cervical Spinal Cord Injury Patients Treated in the Intensive Care Unit

• Han JS
• Kim SH
• Choi JI
• Ha SK
• Kim SD
• Lim DJ
• Kim BJ

• KMID: 2555060
• DOI: http://doi.org/10.32587/jnic.2021.00451

Abstract

Objective
Patients with spinal cord injury (SCI) are often unstable and require intensive care unit (ICU) treatment in the acute phase. This study assists in the prognosis and treatment direction of SCI patients by retrospectively examining and analyzing the clinical characteristics of SCI patients admitted to the ICU.
Methods
In this study, a total of 102 SCI patients were admitted to the ICU of our hospital from February 2013 to March 2019. Based on the medical records, the patient's gender, age, mechanism of injuries, day of hospitalization, surgery timing, tracheostomy, ventilator use, steroid use, underlying disease, and hypotension were investigated. To assess the clinical outcome, the american spinal injury association (ASIA) impairment scale and limb motor grade three weeks and six months after injury was evaluated.
Results
Of the 102 patients, 76 (74.51%) were male, and the average age was 57.57 years. Of these, 87 (85.29%) had spinal surgery, while 30 (34.48%) had surgery within 36 h after injury. High doses of steroids were administered in 15 patients (14.85%). As for the ASIA impairment scale, Grade A at the initial stage of injury reached 15% of all patients but decreased to 5.1% after three weeks and 1.9% after six months.
Conclusion
Early surgery was advantageous in improving the lower extremity motor grade at three weeks of injury. Although steroid use has no significant effect compared to the risk of complications in several previous studies, in this study, it was observed that the ASIA scale improved six months after injury in patients receiving high-dose steroids.

Keyword

Spinal cord injuries; Multiple trauma; Critical care; Neuroprotection; Surgical decompression; Infections