TY  - JOUR
PY  - 2020//
TI  - Trends in demographics and markers of injury severity in traumatic cervical spinal  cord Injury
JO  - Journal of neurotrauma
A1  - Aarabi, Bizhan
A1  - Albrecht, Jennifer S.
A1  - Simard, J. Marc MD
A1  - Chryssikos, Timothy
A1  - Schwartzbauer, Gary
A1  - Sansur, Charles
A1  - Crandall, Kenneth
A1  - Gertner, Melanie
A1  - Howie, Benjamin
A1  - Wessell, Aaron
A1  - Cannarsa, Gregory
A1  - Caffes, Nick
A1  - Oliver, Jeffrey
A1  - Shanmuganathan, Kathirkamanthan
A1  - Olexa, Joshua
A1  - Diaz Lomangino, Cara
A1  - Scarboro, Maureen
SP  - ePub
EP  - ePub
VL  - ePub
IS  - ePub
N2  - Over the past four decades, there have been progressive changes in the epidemiology  of traumatic spinal cord injury (tSCI). We assessed trends in demographic and  injury-related variables in traumatic cervical spinal cord injury (tCSCI) patients  over an 18-year period at a single Level I trauma center. We included all magnetic  resonance imaging confirmed tCSCI patients aged ≥ 15 years for years 2001-2018. Among 1,420 patients, 78.3% were male with mean age 51.5 years. Etiology included  falls (46.9%), motor vehicle collisions (MVC) (34.2%), and sports injuries (10.9%). Median American Spinal Injury Association (ASIA) motor score (AMS) was 44, complete  tCSCI was noted in 29.6% of patients, fracture-dislocations were noted in 44.7% and  median intramedullary lesion length (IMLL) was 30.8 mm (complete injuries 56.3 mm  and incomplete injuries 27.4 mm). Over the study period, mean age and proportion of  falls increased (p<0.001) while proportion due to MVCs and sports injuries decreased  (p<0.001). Incomplete injuries, AMS and the proportion of patients with no fracture  dislocations increased while complete injuries decreased significantly. Mean IMLL  and proportion with hematomyelia did not change significantly. IMLL declined  (p=0.17) and proportion with hematomyelia did not change significantly. In adjusted  regression models, the increase in age and decreases in the prevalence of MVC  mechanism and complete injuries over time remained statistically significant. Changes in demographic and injury-related characteristics of tCSCI patients over  time may help explain the observed improvement in outcomes. Furthermore, improved  clinical outcomes and drop in IMLL may reflect improvements in initial risk  assessment and pre-hospital management, advances in healthcare delivery, and  preventive measures including public education.<p />  <p>Language: en</p>
LA  - en
SN  - 0897-7151
UR  - http://dx.doi.org/10.1089/neu.2020.7415
ID  - ref1
ER  -