Lesión medular traumática en Galicia(1995-2014)estudio de la evolución epidemiológica y resultados clínico-funcionales

Abstract

Introduction Existing literature demonstrates large variations in traumatic Spinal Cord Injury (tSCI) incidence globally. Recents studies indicate that we are attending an epidemiological change in tSCI. This change can originate a series of consequences in the attention model. Knowing the epidemiological and demographic characteristics of the tSCI is essential to plan priorities allocate adequate health resources and also, to identify the guidelines for prevention. Objective To determine the epidemiological characteristics of patients with tSCI during the period 1995-2014 and to analyze the neurological involvement and the predictive factors of the clinical and functional outcomes in that period. Material and method An observational study was conducted with retrospective and prospective monitoring of patients with spinal cord injuries of traumatic etiology who were admitted to the Spinal Cord Injury Unit (SCIU) of the Complejo Hospitalario Universitario de A Coruña in the period January 1995 and December 2014. W estudied socio-demographic variables, comorbidity according to the Charlson index, etiology, neurological assessment variables according to the ASIA/ISCOS classification of spinal cord innjury, type of bone injury, associated injuries, therapeutic management, admission to the Intensive Unit Care (IUC), functional outcome according to the Spinal Cord Independence Measure III (SCIM III), ambulation and walking scale of spinal cord injury Walking Index Spinal Cord Injury II (WISCI II), destiantion and rehabilitation treatment at hospital discharge, and mortality. The statistical analysis was conducted using SPSS program versio 19.0. A descriptive study of variables was carried out expressing the quantitative variables as mean±standard deviation and the qualitative ones as absolute value and percentage with an estimate of their 95% confidence interval. X The comparison of means was made by the t-Student or the Mann-Witney test. The multiple comparison of means was made through the ANOVA or the Kruskal-Wallis test. Tha association of qualitative variables was estimated by means of Chi-Square statistic and the correlation between quantitative variables by means of the Pearson or Spearman correlation coefficient The crude incidence rates for each type of injury was calculated and the standardized rates adjusted for age by the direct method being expressed as rates/100.000 inhabitants/year. Fort he trend analysis of the rate “joinpoint” regression models were used. To determine which variables are associated to the events of interest, we perform multivariate analysis of multiple linear regression and logistics. Patient survival was analyzed using the Kaplan-Meier methodology and Cox proportional hazard model...