Epidemiology and Assessment of Traumatic Spinal Cord Injury With Concomitant Brain Injury: An Observational Study in a Regional Trauma Center
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Objective: To analyze the epidemiological information of patients with traumatic spinal cord injury (SCI) and concomitant traumatic brain injury (TBI) and to suggest points to be aware of during the initial physical examination of patients with SCI.Methods: This study was a retrospective, observational study conducted in a regional trauma center. All the records of patients diagnosed with traumatic SCI between 2016 and 2020 were reviewed. A total of 627 patients with confirmed traumatic SCI were hospitalized. A retrospective study was conducted on 363 individuals.Results: The epidemiological data of 363 individuals were investigated. Changes in American Spinal Injury Association Impairment Scale (AIS) scores in patients with SCI were evaluated. The initial evaluation was performed on average 11 days after the injury, and a follow-up examination was performed 43 days after. Fourteen of the 24 patients identified as having AIS A and SCI with concomitant TBI in the initial evaluation showed neurologic level of injury (NLI) recovery with AIS B or more. The conversion rate in patients with SCI and concomitant TBI exceeded that reported in previous studies in individuals with SCI.Conclusions: Physical, cognitive, and emotional impairments caused by TBI present significant challenges in rehabilitating patients with SCI. In this study, the influence of concomitant TBI lesions could have caused the initial AIS assessment to be incorrect.
Abstract
Objective: To analyze the epidemiological information of patients with traumatic spinal cord injury (SCI) and concomitant traumatic brain injury (TBI) and to suggest points to be aware of during the initial physical examination of patients with SCI.Methods: This study was a retrospective, observational study conducted in a regional trauma center. All the records of patients diagnosed with traumatic SCI between 2016 and 2020 were reviewed. A total of 627 patients with confirmed traumatic SCI were hospitalized. A retrospective study was conducted on 363 individuals.Results: The epidemiological data of 363 individuals were investigated. Changes in American Spinal Injury Association Impairment Scale (AIS) scores in patients with SCI were evaluated. The initial evaluation was performed on average 11 days after the injury, and a follow-up examination was performed 43 days after. Fourteen of the 24 patients identified as having AIS A and SCI with concomitant TBI in the initial evaluation showed neurologic level of injury (NLI) recovery with AIS B or more. The conversion rate in patients with SCI and concomitant TBI exceeded that reported in previous studies in individuals with SCI.Conclusions: Physical, cognitive, and emotional impairments caused by TBI present significant challenges in rehabilitating patients with SCI. In this study, the influence of concomitant TBI lesions could have caused the initial AIS assessment to be incorrect.
참고문헌 (33)
- Budisin B, "Traumatic brain injury in spinal cord injury : frequency and risk factors", J Head Trauma Rehabil, 31, pp.E33~E42 (2016)
- Bradbury CL, "Traumatic brain injury in patients with traumatic spinal cord injury : clinical and economic consequences", Arch Phys Med Rehabil, 89(12 Suppl), pp.S77~S84 (2008)
- Garlanger KL, "Functional outcomes in patients with co-occurring traumatic brain injury and spinal cord injury from an inpatient rehabilitation facility’s perspective", J Spinal Cord Med, 41, pp.718~730 (2018)
- Macciocchi SN, "Effect of co-morbid traumatic brain injury on functional outcome of persons with spinal cord injuries", Am J Phys Med Rehabil, 83, pp.22~26 (2004)
- Burns AS, "Patient selection for clinical trials : the reliability of the early spinal cord injury examination", J Neurotrauma, 20, pp.477~482 (2003)
- Hagen EM, "Traumatic spinal cord injury and concomitant brain injury : a cohort study", Acta Neurol Scand Suppl, (190), pp.51~57 (2010)
- Tolonen A, "Traumatic brain injury is under-diagnosed in patients with spinal cord injury", J Rehabil Med, 39, pp.622~626 (2007)
- Ruff RM, "Recommendations for diagnosing a mild traumatic brain injury : a National Academy of Neuropsychology education paper", Arch Clin Neuropsychol, 24, pp.3~10 (2009)
- de Guise E, "The Montreal Cognitive Assessment in persons with traumatic brain injury", Appl Neuropsychol Adult, 21, pp.128~135 (2014)
- Macciocchi S, "Spinal cord injury and co-occurring traumatic brain injury : assessment and incidence", Arch Phys Med Rehabil, 89, pp.1350~1357 (2008)
- de Guise E, "The mini-mental state examination and the Montreal Cognitive Assessment after traumatic brain injury : an early predictive study", Brain Inj, 27, pp.1428~1434 (2013)
- Sun H, "Assessment of cognitive dysfunction in traumatic brain injury patients : a review", Forensic Sci Res, 2, pp.174~179 (2017)
- Miotto EC, "Cognitive deficits in patients with mild to moderate traumatic brain injury", Arq Neuropsiquiatr, 68, pp.862~868 (2010)
- Biering-Sørensen F, "International Spinal Cord Injury Core Data Set(version 3. 0)-including standardization of reporting", Spinal Cord, 61, pp.65~68 (2023)
- Singh A, "Global prevalence and incidence of traumatic spinal cord injury", Clin Epidemiol, 6, pp.309~331 (2014)
- Lee BS, "Epidemiological changes in traumatic spinal cord injuries for the last 30 years(1990-2019)in South Korea", Spinal Cord, 60, pp.612~617 (2022)
- Yang NP, "The incidence and characterisation of hospitalised acute spinal trauma in Taiwan--a population-based study", Injury, 39, pp.443~450 (2008)
- Chacko V, "Management of spinal cord injury in a general hospital in rural India", Paraplegia, 24, pp.330~335 (1986)
- Ning GZ, "Epidemiology of traumatic spinal cord injury in Asia : a systematic review", J Spinal Cord Med, 35, pp.229~239 (2012)
- The 2021annual statistical report complete public version for the Spinal Cord Injury Model Systems, "National Spinal Cord Injury Statistical Center(NSCISC)", University of Alabama at Birmingham, 1~161 (2022)
- Holly LT, "Cervical spine trauma associated with moderate and severe head injury : incidence, risk factors, and injury characteristics", J Neurosurg, 96(3 Suppl), pp.285~291 (2002)
- Barbetta DC, "Spinal cord injury epidemiological profile in the Sarah Network of Rehabilitation Hospitals-a Brazilian population sample", Spinal Cord Ser Cases, 4, pp.32~ (2018)
- International Transport Forum, "Road safety annual report 2020", International Transport Forum, pp.1~64 (2020)
- Ha Seong Kim, "Epidemiology of Spinal Cord Injury: Changes to Its Cause Amid Aging Population, a Single Center Study", Annals of Rehabilitation Medicine, 45(1), pp.7~15 (2021), 대한재활의학회[DOI]
- Harper A, "Falls in older adults : causes, assessment and management", Medicine, 49, pp.32~37 (2021)
- Rhee JM, "Nonoperative management of cervical myelopathy : a systematic review", Spine(Phila Pa 1976), 38(22 Suppl 1), pp.S55~S67 (2013)
- Chamberlain JD, "Epidemiology and contemporary risk profile of traumatic spinal cord injury in Switzerland", Inj Epidemiol, 2, pp.28~ (2015)
- Knútsdóttir S, "Epidemiology of traumatic spinal cord injuries in Iceland from 1975 to 2009", Spinal Cord, 50, pp.123~126 (2012)
- Kirshblum S, "Characterizing natural recovery after traumatic spinal cord injury", J Neurotrauma, 38, pp.1267~1284 (2021)
- Khorasanizadeh M, "Neurological recovery following traumatic spinal cord injury : a systematic review and meta-analysis", J Neurosurg Spine, 30, pp.683~699 (2019)
- Spiess MR, "Conversion in ASIA impairment scale during the first year after traumatic spinal cord injury", J Neurotrauma, 26, pp.2027~2036 (2009)
- Ely EW, "Monitoring sedation status over time in ICU patients : reliability and validity of the Richmond Agitation-Sedation Scale(RASS)", JAMA, 289, pp.2983~2991 (2003)
- Armstrong AJ, "Achieving assessor accuracy on the International Standards for Neurological Classification of Spinal Cord Injury", Spinal Cord, 55, pp.994~1001 (2017)