title: Survival, neurological recovery and morbidity after spinal cord injuries following road accidents in Israel.
abstract: METHODS
  A retrospective cohort study.
  
  
  OBJECTIVE
  Assess outcomes in patients with spinal cord injuries (SCI) following road accidents, and factors that affect them.
  
  
  METHODS
  Loewenstein Rehabilitation Hospital, Raanana, Israel.
  
  
  METHODS
  A total of 143 patients admitted for rehabilitation between 1962 and 2004.
  
  
  METHODS
  Survival rates were estimated using the product limit (Kaplan-Meyer) method and their association with risk factors was analyzed with the Cox model. Neurological recovery was determined by comparing the Frankel grade at admission to rehabilitation and at discharge. The relation between recovery and various factors was tested with logistic regression.
  
  
  RESULTS
  The risk of SCI in road accidents is higher among car drivers and motorcycle or bicycle riders. Median survival was 43 years. Survival was negatively associated with age at injury (P<0.0002) and with diagnosis of pressure sores (P=0.0065). Recovery of at least one Frankel grade occurred in 29.1% of patients. Useful recovery (upgrade to Frankel grade D or E) occurred in 23.1% of all patients. Neurological recovery was negatively associated with the severity of neurological deficit (P<0.001) and with thoracic injuries (P=0.046). The most common complications were pressure sores and those of the urinary and respiratory systems.
  
  
  CONCLUSIONS
  In SCI following road accidents, survival rates were higher and recovery rates lower than in mixed types of trauma. This may be related to better compensation followed by better nursing for road accident victims in Israel, which may prevent life-shortening complications, and to more severe injuries caused by road accidents.
authors.affiliation: Spinal Department, Loewenstein Rehabilitation Hospital, Raanana, Israel.
authors.forename: E
authors.initials: E
authors.lastname: Tchvaloon
authors.forename: L
authors.initials: L
authors.lastname: Front
authors.forename: I
authors.initials: I
authors.lastname: Gelernter
authors.forename: J
authors.initials: J
authors.lastname: Ronen
authors.forename: V
authors.initials: V
authors.lastname: Bluvshtein
authors.forename: A
authors.initials: A
authors.lastname: Catz
mesh_terms: D000063:Accidents, Traffic / Q000401:mortality*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D007557:Israel; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009017:Morbidity; D003668:Pressure Ulcer / Q000209:etiology; D020127:Recovery of Function; D013119:Spinal Cord Injuries / Q000150:complications* / Q000401:mortality* / Q000473:pathology; D016019:Survival Analysis; D015996:Survival Rate; D014552:Urinary Tract Infections / Q000209:etiology