title: [Analysis of the risk factors for early death in acute severe traumatic cervical spinal cord injury].
abstract: OBJECTIVE
  To survey the risk factors for early death of patients with acute severe traumatic cervical spinal cord injury.
  
  
  METHODS
  A retrospective analysis of data of consecutive patients with acute severe traumatic cervical spinal cord injury admitted from January 1st 1994 to October 1st 2012 were made. The patients died within 30 days or not were allocated for death group or survival group. The risk factors for early death were analyzed through univariate analysis and logistic analysis.
  
  
  RESULTS
  Among 1093 patients with acute traumatic cervical spinal cord injury, 352 patients with severe injury were included, and the early death rate was 14.49% (51/352). The leading causes of spinal cord injury were vehicle accidents (153 cases) and falls (117 cases). The main causes of early death were respiratory failure (16 cases), multiple organ failure (MOF, 14 cases) and gastrointestinal bleeding (11 cases). Combining the results of univariate and logistic analysis, it was found that high acute physiology and chronic health evaluation II(APACHEII) score [>15, odds ratio (OR)=11.595, P=0.000], high damage level (OR=3.519, P=0.032), hyponatremia (OR=6.316, P=0.000), neurogenic shock (OR=6.209, P=0.000), pulmonary infection (OR=14.627, P=0.000) and tracheostomy (OR=8.983, P=0.000) were risk factors for early death of patients with acute severe traumatic cervical spinal cord injury, however, the impact of gender, age, surgery, fracture and dislocation, high central fever, and administration of steroids on early death of patients with acute severe traumatic cervical spinal cord injury were uncertain.
  
  
  CONCLUSIONS
  The factors reflecting disease severity and occurrence of related complications were more important in predicting the early death among patients with acute severe traumatic cervical spinal cord injury, while the influence of age, surgical manipulation etc. were minor factors.
authors.affiliation: Department of Critical Care Medicine, Peking University Third Hospital, Beijing, China.
authors.forename: Yu-xin
authors.initials: YX
authors.lastname: Leng
authors.forename: Chun-yan
authors.initials: CY
authors.lastname: Nie
authors.forename: Zhi-yuan
authors.initials: ZY
authors.lastname: Yao
authors.forename: Xi
authors.initials: X
authors.lastname: Zhu
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D002423:Cause of Death; D016638:Critical Illness; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009102:Multiple Organ Failure; D012131:Respiratory Insufficiency; D012189:Retrospective Studies; D012307:Risk Factors; D013119:Spinal Cord Injuries / Q000401:mortality*