Analysis of clinical outcome risks in patients with vertebro-thoracic trauma
Background. Spine injury is one of the most discussed problems of modern medicine. In 36–72 % of the victims, spinal cord injury is combined with damage to other organs and systems. The vertebro-thoracic trauma is one of the varieties of multiple trauma. The purpose of the study is to examine and analyze the clinical outcome risks of the fatal outcome of the traumatic process in patients with vertebro-thoracic trauma. Materials and methods. This article represents data analysis of 157 cases of vertebro-thoracic injuries. The analysis of clinical outcome risks was performed depending on the clinical and anatomical signs of spine injury, on the degree of damage to the spinal cord based on motor and sensory functions, as well as severity of injury according to the standardized Injury Severity Score (ISS). Results. Catastrophic clinical outcome risk occurred in patients with cervical spine damage, or multiple injuries, or damage, which belongs to type C according to the classification of Association for Osteosynthesis/Association for the Study of Internal Fixation (AO/ASIF), or in patients with trauma severity of 45 points on the ISS scale. Critical clinical outcome risk was in patients with fracture and dislocation of vertebra, or damage of the vertebra posterior half rings, or damage that caused disruption of motor and sensory functions according to Frankel A and Frankel В qualification type, or in patients with trauma severity 36–45 points on the ISS scale. Substantial clinical outcome risk was in patients with upper thoracic (Th1–6) spine damage, or multilevel spine injuries, or damage, which belongs to type В according to the classification of AO/ASIF, or damage that caused disruption of motor and sensory functions according to Frankel С qualification type, or in patients with trauma severity 26–35 points on the ISS scale. Insubstantial clinical outcome risk was in patients with lower thoracic (Th7–12) spine damage, or damage, which belongs to type А according to the classification of AO/ASIF, or damage that caused disruption of motor and sensory functions according to Frankel D qualification type, or in patients with trauma severity of up to 25 points on the ISS scale. Minimal clinical outcome risk was in patients with lumbar spine damage, or damage that caused disruption of motor and sensory functions according to Frankel E qualification type. Conclusions. Vertebro-thoracic injuries are an important medical and social problem, which is characterized primarily by a significant clinical outcome risk, which entails severe social and economic consequences. The outcome risk ranges from minimal to catastrophic, indicating a different strength and intensity of exposure to the risk-generative factors.
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Guryev S. O. Mathematical estimation of clinical risks of death at patients with pelvic trauma / S. O. Guryev, M. A. Maksymenko // Ukrajinsjkyjzhurnaltelemedycyny ta medychnojitelematyky. – 2012. – № 2. – P. 58–63.
Leontev M. A. Epidemiology of spinal cord injury and frequency of complete anatomical damage to the spinal cord / M. A. Leontev// Meditsina v Kuzbasse. – 2003. – Spets. vypusk № 2. – P. 37–38.
Morozov I. N.Epidemiology of vertebral-spinal cord injury (review) / I. N. Morozov, S. G. Mlyavykh// Meditsinskiyalmanakh. – 2011. – № 4 (17). – P. 157– 159.
A protocol recommended for treating acute complicated and uncomplicated spinal injuries in adult patients / V. V. Krylov, A. A. Grin, A. A. Lutsik, [at al.] // Voprosyneyrokhirurgii. – 2014. – № 6. – P. 60–67.
Slynjko Je. I. Urgent neurosurgical help with complicated vertebral and spinal trauma in Ukraine (program report) / Je. I. Slynjko// Ukrajinsjkyjnejrokhirurghichnyjzhurnal. – 2005. – № 3. – P. 63–74.
Cvjakh A. I.Analysis of clinical outcome risks in patients with combined pelvic trauma / A. I. Cvjakh, S. O. Gur’yev/ Trauma. – 2015. – Vol. 16, № 4. – P. 35–40.
Benzel E. C. Spine surgery: techniques, complication avoidance, and management // edited by E. C. Benzel. – 2nd ed. – Elsevier Churchill Livingstone. – 2005. – 2205 p.
Chipman J. G. Early surgery for thoracolumbar spine injuries decreases complications / J. G. Chipman, W. E. Deuser, G. J. Beilman // Journal of Trauma-Injury Infection & Critical Care. – 2004. – Vol. 56, № 1. – P. 52–57.
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