title: Analysis of prehospital care and emergency room treatment of patients with acute traumatic spinal cord injury: a retrospective cohort study on the implementation of current guidelines.
abstract: METHODS
  Retrospective cohort study.
  
  
  OBJECTIVE
  The aims of the current study were (i) to analyze prehospital and emergency room treatment of patients with acute traumatic spinal cord injury (SCI) and (ii) to analyze whether recommendations given by the current guidelines are implemented.
  
  
  METHODS
  German level I trauma center.
  
  
  METHODS
  All patients suffering from traumatic SCI who were initially surgically treated in our hospital in the period from January 2008 to December 2013 were included in this study. Available data documented as a standard procedure in our trauma center included patient's demographic and medical information, as well as trauma mechanisms, cause of injury, neurological diagnosis and detailed clinical information about prehospital and early hospital management procedures. Retrospectively, statistical analysis was performed to describe spinal immobilization rates, transportation times and methylprednisolone administration.
  
  
  RESULTS
  A total of 133 patients (mean age: 50.5±21.2 years) met the inclusion criteria. Immobilization was performed on 69.9% of the patients with traumatic SCI. From 60 patients suffering from cervical traumatic SCI, 47 patients had a cervical collar. Full immobilization was only performed in 34 of these 60 patients. Mean time from accident site to emergency room was 61.3±28.7 min. In 25 out of the 133 patients included in the current study, early surgery was not possible because of insufficient circulation and/or increased intracranial pressure. A total of 108 patients could be prepared for early surgery within 322.8±254.1 min after the accident.
  
  
  CONCLUSIONS
  The current study shows that recommendations of the current literature and guidelines are mostly followed.
authors.affiliation: Department of Trauma Surgery and Orthopedics, BG Trauma Centre Ludwigshafen, Ludwigshafen, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Kreinest
authors.affiliation: Department of Trauma Surgery and Orthopedics, BG Trauma Centre Ludwigshafen, Ludwigshafen, Germany.
authors.forename: L
authors.initials: L
authors.lastname: Ludes
authors.affiliation: Department of Paraplegiology, BG Trauma Centre Ludwigshafen, Ludwigshafen, Germany.
authors.forename: A
authors.initials: A
authors.lastname: Türk
authors.affiliation: Department of Trauma Surgery and Orthopedics, BG Trauma Centre Ludwigshafen, Ludwigshafen, Germany.
authors.forename: P A
authors.initials: PA
authors.lastname: Grützner
authors.affiliation: Department of Paraplegiology, BG Trauma Centre Ludwigshafen, Ludwigshafen, Germany.
authors.forename: B
authors.initials: B
authors.lastname: Biglari
authors.affiliation: Department of Trauma Surgery and Orthopedics, BG Trauma Centre Ludwigshafen, Ludwigshafen, Germany.
authors.forename: S
authors.initials: S
authors.lastname: Matschke
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004632:Emergency Medical Services / Q000379:methods* / Q000706:statistics & numerical data; D004638:Emergency Treatment / Q000379:methods* / Q000706:statistics & numerical data; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D012189:Retrospective Studies; D013119:Spinal Cord Injuries / Q000453:epidemiology* / Q000628:therapy*; D061665:Time-to-Treatment; D055815:Young Adult