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Outcome of Traumatic Cervical Spinal Cord Injury in a General ICU: A 5-Year Review

Adigun TA*, Sanusi AA and Idowu OK

Introduction: Intensive care management is essential for monitoring, mechanical ventilation and inotropic support as part of the overall management of patients with cervical spinal cord injury. This study aimed to determine the outcome and factors affecting the outcome of patients with traumatic cervical spinal cord injury (TCSCI) admitted into a general Intensive Care Unit (ICU).

Methods: This was a retrospective study of 32 patients with TCSCI admitted into general ICU of University College Hospital from January 2015 to December 2019. The information retrieved included patient´s demographic characteristics, etiology of injury, level of injury, inotrope use, ventilator use, ICU days and outcome. Descriptive statistics was used to get proportion of demographic characteristics while association between outcome mortality and demographic and clinical parameters was determined with chi square test and the level of significance was set at P<0.05.

Results: There were 25 (78.1%) males and 7 (21.9%) females. The patients age range from 7 to 77 years with a mean age of 38.2 ± 16.16. Motor vehicular accident accounted for 87.5% of cervical injury. Cervical spinal injury level at C3 was in 18 patients, C4 in 11 patients and C5 in 3 patients. Five patients had other associated injury (head injury in 2 patients, humeral fracture in 2 patients and ribs fracture in one patient). Fifteen patients died with a mortality rate 46.9%. Mortality was more in females (71.4%) (P=0.141) and in patients aged less than 30 (55.6%) (P=0.58). Patients who stayed less than 7 days in ICU, those who were mechanically ventilated and those who had inotropic support had poor outcome in ICU (P=0.04, P=0.006 & P= 0.001) respectively.

Conclusion: The mortality in patients with cervical spine injury was high in our center. Shorter length of ICU stay, use of mechanical ventilation and inotropic support were significant risk factors contributing to mortality.