title: Spinal cord injury: epidemiological study of 386 cases with emphasis on those patients admitted more than four hours after the trauma.
abstract: We studied 386 cases of spinal cord injury to analyze the follow up of the patients admitted most of the time more than four hours, the majority of the injuries happening far from the attending health service and first specialized care received long after the accident. This is a clinical study based on data collected during hospitalization of the patients, operated or not, in a Brazilian public health service. The lesion mainly seen was fracture and dislocation, isolated or on multiple levels, and the most important clinical complications were due to respiratory failure and hypotension, especially because 73.8% were from outside and they were admitted more then four hours after the trauma. The mortality rate was 11.9%, but just 2.1% had undergone a surgery. The complications resulted in major risk of death when the trauma was at the cervical level and the patients were over 50 years old, especially when admitted more than four hours after the trauma. We emphasize the importance of the first health care concerning the clinical treatment, aiming to reduce the mortality rate.
authors.affiliation: State University of Campinas, São Paulo, Brazil. manoelbaldoino@uol.com.br
authors.forename: Manoel Baldoino
authors.initials: MB
authors.lastname: Leal-Filho
authors.forename: Guilherme
authors.initials: G
authors.lastname: Borges
authors.forename: Bruno Ribeiro de
authors.initials: BR
authors.lastname: Almeida
authors.forename: Aline de Almeida Xavier
authors.initials: Ade A
authors.lastname: Aguiar
authors.forename: Marcelo Adriano da Cunha e Silva
authors.initials: MA
authors.lastname: Vieira
authors.forename: Karoline da Silva
authors.initials: Kda S
authors.lastname: Dantas
authors.forename: Ricardo Keyson Paiva de
authors.initials: RK
authors.lastname: Morais
authors.forename: Carlos Rogério Nogueira dos
authors.initials: CR
authors.lastname: Santos
authors.forename: Sumihara de Sousa
authors.initials: Sde S
authors.lastname: Mendes
authors.forename: Luciana Maria
authors.initials: LM
authors.lastname: Pinheiro
mesh_terms: D000058:Accidental Falls / Q000706:statistics & numerical data; D000063:Accidents, Traffic / Q000706:statistics & numerical data; D000293:Adolescent; D000328:Adult; D001938:Brazil / Q000453:epidemiology; D004632:Emergency Medical Services / Q000706:statistics & numerical data / Q000600:supply & distribution; D004638:Emergency Treatment / Q000706:statistics & numerical data*; D005260:Female; D005392:First Aid; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D008875:Middle Aged; D009049:Motorcycles; D010343:Patient Admission / Q000706:statistics & numerical data*; D013119:Spinal Cord Injuries / Q000453:epidemiology* / Q000401:mortality / Q000628:therapy*; D013997:Time Factors; D014187:Transportation of Patients; D014505:Urban Population