ORIGINAL

The Epidemiological Characteristics and Type of Treatment in Iranian Patients with Traumatic Cervical Spine Injuries: a cohort study

Características Epidemiológicas e Tipo de Tratamento em Pacientes Iranianos com Lesões Traumáticas da Coluna Cervical: um estudo coorte

  • Saeed Gharooee Ahangar 1    Saeed Gharooee Ahangar 1
  • Iran Chanideh 1    Iran Chanideh 1
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Resumo

Introdução: lesões traumáticas da coluna cervical (ICS) são uma das condições mais graves em termos de morbidade e incapacidade. Alguns estudos avaliam estas lesões no Irã. Objetivo: este estudo teve como objetivo investigar as características epidemiológicas das ICS traumáticas e os fatores que afetam o tipo de tratamento na população iraniana. Métodos: Neste estudo de coorte retrospectivo, foram incluídos 289 pacientes com ICS traumáticas admitidos no Hospital Taleghani, Irã, no período de abril de 2017 a março de 2023. Os dados foram coletados por um neurocirurgião por meio de um checklist desenvolvido com base nos objetivos do estudo. Para identificar fatores associados ao tratamento em pacientes traumáticos e selecionar variáveis para o modelo de regressão logística (Método Enter), foi realizada uma análise de regressão univariada inicial. Posteriormente, aplicou-se regressão logística múltipla para calcular odds ratio ajustados. Resultados: a média de idade dos pacientes foi de 42,28 anos (DP: 17,05), sendo 147/192 (76,6%) do sexo masculino. Os mecanismos de trauma foram acidentes automobilizados em 78,6%, quedas em 17,2% e outros em 4,2%. Os níveis mais frequentemente afetados foram C2 (33,3%) e C5 (18,8%). Déficits neurológicos estavam presentes em 67 pacientes (37,4%). Por fim, 74 (38,5%) dos pacientes foram tratados com cirurgia aberta e em 118 (61,5%) foram considerados tratamento conservador. A taxa de mortalidade hospitalar nesta série foi de 13%. O resultado do modelo de regressão logística múltipla indica que, entre essas 5 variáveis, apenas o déficit neural está significativamente relacionado ao tipo de tratamento (OR=4,25, CI: 1,47-12,24, p=0,007). Conclusão: os ICS traumáticos não só afetam um indivíduo, mas também sofrem sobrecarga na família e na nação, criando estresse econômico e psicossocial. Medidas de segurança simples como discutidas, programa de conscientização adequado, educação das pessoas, formulação de políticas nacionais e envolvimento de ONGs e treinamento de profissionais de cuidados de saúde primários ajudarão a reduzir a incidência de lesões da coluna cervical nesta região.

Palavras-chave

Trauma; Lesões da coluna cervical; Irã; Tratamento

Abstract

Introduction: traumatic cervical spine injuries (CSIs) are one of the most severe conditions in terms of morbidity and disability. A few studies assess these injuries in Iran. Objective: this study aimed to investigate the epidemiological characteristics of traumatic CSIs and the factors affecting the type of treatment in the Iranian population. Methods: in this retrospective cohort study, 289 patients with traumatic CSIs admitted to Taleghani Hospital, Iran, in a period from April 2017 to March 2023, were enrolled. Data were collected by a neurosurgeon using a checklist developed based on the study objectives. To identify factors associated with treatment in traumatic patients and select variables for the logistic regression model (Enter Method), an initial univariate regression analysis was conducted. Subsequently, multiple logistic regression was applied to calculate adjusted odds ratios. Results: the mean age of the patients was 42.28 years (SD: 17.05), and 147/192 (76.6%) were males. The trauma mechanisms were motorized vehicle accidents in 78.6%, falls in 17.2%, and others in 4.2%. The most frequently affected levels were C2 (33.3%) and C5 (18.8%). Neurologic deficits were present in 67 patients (37.4%). Ultimately, 74 (38.5%) of the patients were treated with open surgery, and 118 (61.5%) were considered conservative treatment. The inhospital mortality rate in this series was 13%. The result of the multiple logistic regression model indicates that, among these 5 variables, only the neural deficit is significantly related to the type of treatment (OR=4.25, CI: 1.47 -12.24, p=0.007). Conclusion: the traumatic CSIs not only affect an individual but also suffer burden in the family and nation by creating economic and psychosocial stress. Simple safety measures as discussed, proper awareness programme, educating people, national policy making, and involvement of NGOs and training primary health care workers will help in reducing the incidence of cervical spine injuries in this region.

Keywords

Trauma; Cervical spine injuries; Iran; Treatment

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1Kermanshah University of Medical Science, Kermanshah, Iran.

 

Received May 31, 2024

Accepted Jun 10, 2024

JBNC  Brazilian Journal of Neurosurgery

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