Akademik Veri Yönetim Sistemi
Journal of Critical and Intensive Care, cilt.14, ss.89-95, 2023 (ESCI)
ABSTRACT
Aim: In this study, we aimed to evaluate the surgical process, anesthesia management and intensive care followup of patients with traumatic cervical spinal cord injury (TCSCI) admitted to the Intensive Care Unit (ICU)
and to determine the factors affecting patient outcomes.
Study Design and Methods: This study was carried out as a single-center, cross-sectional, retrospective study.
Surgically treated patients with TCSCI were retrospectively evaluated in terms of age, sex, etiology of trauma,
fracture side, Glasgow coma scale (GCS), Acute Physiology and Chronic Health Evaluation II score (APACHE
II), neurological outcome, mechanical ventilation requirement, inotropic therapy requirement, nosocomial
infections, ICU length of stay, ward length of stay and ICU mortality.
Results: A total of 41 patients were included in the study. There were 10 (24.39%) female patients in our
study and the median age was 48(33.5–66.0) years. The most common cause of trauma was fall from height in
14 patients (34.14%), followed by traffic accidents in 12 patients (29.26%). The most common involvement
was C7 fracture in 7 (17.07%) patients and C4-C5 listhesis in 8 (19.52%) patients. Fourteen (34.14%) of
the patients underwent 360-degree stabilization (both anterior and posterior), 24 (58.53%) underwent only
anterior stabilization, and 3 (7.31%) underwent only posterior stabilization and the median APACHE II score
was 10.16 (4–26). The median duration of ICU stay was 2 (1.0–5.5) days. The mortality rate was 12.9%; it was
36.4% in patients with neurologic deficits and 3.3% in patients without neurologic deficits (p=0.014)
Conclusions: Surgical approach, anesthesia management and intensive care management are complementary
for TCSCI patients. The severity of the neurological deficit has a direct effect on the survival of the patients.
Keywords: Cervical vertebra trauma, anterior and posterior stabilization, ICU, neurosurgery