title: Increased susceptibility of patients with cervical cord lesions to peptic gastrointestinal complications.
abstract: The incidence and risk factors in the development of hemorrhaging and perforating gastrointestinal (GI) lesions in 408 patients with cervical column/cord injury were studied retrospectively. Most injuries were caused by blunt trauma (94.1%). Male patients predominated (83.6%); the mean patient age was 35.8 years. Of the 408 patients, 190 (46.6%) had complete cord deficits, 111 (27.2%) had incomplete deficits, and 107 (26.2%) were intact. Admission shock (systolic BP less than 100 mm Hg) was present in 31.6% and 20.7% of patients with complete and incomplete lesions, respectively, and in 4.7% of those intact. Patients with complete deficits received corticosteroids for 2 days; patients with incomplete deficits received them for 7 to 10 days. Eleven of the 107 intact patients (10.3%) received steroids. All patients received standard antacid therapy. Nine patients without previous GI disease developed peptic ulcerations: six gastric and three duodenal lesions (six were perforated) that required surgical intervention; all occurred in patients with complete deficits. Both the 4.7% incidence of the lesions in those patients compared with the other victims of cervical trauma and an estimated 0.1% incidence among more than 6,000 other seriously injured patients are significant (p less than 0.005, p less than 0.001). Steroids were not an ulcerogenic factor.
mesh_terms: D000293:Adolescent; D000328:Adult; D000863:Antacids / Q000627:therapeutic use; D001424:Bacterial Infections / Q000150:complications; D002574:Cervical Vertebrae / Q000293:injuries; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000209:etiology / Q000517:prevention & control; D005938:Glucocorticoids / Q000009:adverse effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D009333:Neck; D010437:Peptic Ulcer / Q000209:etiology*; D010439:Peptic Ulcer Perforation / Q000209:etiology; D012189:Retrospective Studies; D012306:Risk; D012769:Shock / Q000150:complications; D013119:Spinal Cord Injuries / Q000150:complications* / Q000401:mortality; D013997:Time Factors
chemical_list: D000863:Antacids; D005938:Glucocorticoids