OBJECTIVETrauma in India is an increasingly significant problem, particularly in light of rapid development and increasing motorization. Social changes are resulting in alterations in the epidemiology of trauma. The aim of the study was to assess the various epidemiological parameters that influence the cause of injury in the patients admitted to a major trauma centre in northern India.

METHODSAn observational study of 748 patients chosen by random assortment was carried out over a period of 1 year (August 2008 to July 2009). Age, sex, injury type and pattern were noted. Injury mode of upper and lower limbs was also noted.

RESULTSInjuries occur predominately in the age group of 15-30 years. Males incurred more injury with male to female ratio of 6:1. The most vulnerable group was motorcycle users. Among the injured, farmers were the most commonly involved. Blunt injuries (94.92%) were much more common than penetrating injuries. Among patients with head injury, two-wheeler related accidents were the most common (40.3%). Most spinal cord injuries were caused by falls from height (51.09%). Most lower limb fractures were simple type. Compound fractures of the lower limb were more common than upper limb fractures.

CONCLUSIONStrict enforcement of traffic rules, combined with improved infrastructure and behavior change can decrease the burden of road traffic accidents in India and other developing countries. This study could assist in raising the profile of road traffic accidents as a public health problem which needs to be addressed as a preventable cause of mortality and morbidity, and planning appropriate interventions for this major challenge. Preventive strategies should be made on the basis of these epidemiological trends.

Accidents, Traffic ; statistics & numerical data ; Adolescent ; Adult ; Aged ; Craniocerebral Trauma ; epidemiology ; Female ; Humans ; India ; epidemiology ; Male ; Middle Aged ; Spinal Cord Injuries ; epidemiology ; Wounds and Injuries ; epidemiology

STUDY DESIGN: Prospective case series. PURPOSE: To analyze the demographic picture of the patients suffering from compression myelopathy due to various spinal problems. Overview of Literature: There is a lack of literature depicting demographic picture of such patients with spinal injuries as most of the articles have shown the epidemiology of spinal cord injuries either managed conservatively or operatively. None have focused on the patients with compressive myelopathy requiring surgeries. METHODS: Patients with spinal pathologies with a neurological deficit due to compressive myelopathy requiring surgical decompression of dorsal and thoracolumbar region were studied. The different kinds of etiologies, the demographic profiles involved, the involvement of various regions of spine in each of the etiologies, sex distribution of different etiologies, association of age and sex with the occurrence of paraplegia, and association of thoracolumbar junction (TLJ) involvement by age and sex were studied. This study addressed the dorsal and TLJ till L2 vertebrae surgically treated by anterior transthoracic transpleural approach. RESULTS: With regard to gender, 75% of the females and 67.3% of the males were paraplegic but there was no relationship between gender and the occurrence of paraplegia (p >0.05). There was also no association between TLJ involvement and the age and sex of the patients (p >0.05). Seventy percent of the patients were paraplegic with a mean age of 38.90 years and 30% were paraparetic with a mean age of 43.43 years. Male to female ratio stood at 4.43:1. CONCLUSIONS: Traumatic spine in females is increasing. The occurrence of paraplegia and involvement of TLJ is not affected by the age and the sex of the patients. Deep epidemiological understanding of spinal pathologies can lead to a better appreciation of the potential impact of health care management strategies and health policies to prevent and minimize their consequences considering limited worldwide reports on the same.
Asian Continental Ancestry Group* ; Decompression, Surgical ; Delivery of Health Care ; Demography ; Epidemiology ; Female ; Health Policy ; Humans ; Male ; Paraplegia ; Pathology ; Prospective Studies ; Sex Distribution ; Spinal Cord Compression* ; Spinal Cord Diseases ; Spinal Cord Injuries ; Spinal Injuries ; Spine

Objective To explore the relationship among post-traumatic stress disorder(PTSD),social support and quality of life in patients with spinal cord injury(SCI)after a long recovery in China and investigate the factors influencing the quality of life. Methods In this cross-sectional study,206 SCI patients who were hospitalized in 9 hospitals were enrolled.Data collection was performed using general information,the Post-Traumatic Stress Disorder Checklist-Civilian version,the social support scales,and the World Health Organization Quality of Life-Abbreviated version.The data were statistically analyzed using
China/epidemiology* ; Cross-Sectional Studies ; Humans ; Quality of Life ; Social Support ; Spinal Cord Injuries/psychology* ; Stress Disorders, Post-Traumatic/epidemiology*

OBJECTIVE: The patients with spinal cord injury (SCI) suffered by a lot of complications that influence the quality of life both physically and mentally. The purpose of this study was to evaluate the epidemiology of patients with spinal cord injury in incidence of the complication according to the injury level and period. METHOD: Retrospective study was done in 554 patients with SCI who discharged from Yonsei University Medical Center from January, 1987 to December, 1996. We investigated the incidence of each complication such as respiratory, cardiovascular, genitourinary, musculoskeletal, and dermatologic complications according to the neurologic level and each period (1987~1991, 1992~1996). RESULTS: Among the 554 cases, urologic complication (40.3%) was the most common complication followed by dermatologic (39.0%), musculoskeletal (33.6%), cardiovascular (27.1%) and so on. The most common complications of each system were autonomic dysreflexia (13.2%) in cardiovascular, pneumonia (9.6%) in respiratory, contracture (27.8%) in musculoskeletal, urinary tract infection (34.3%) in urologic, hemorrhoid in gastrointestinal, and central pain (24.0%) in neurogenic complications. The most common site of pressure sore was sacral area (58.9%). There was no significant difference in each complication according to the injury period. CONCLUSION: Urologic complication was the most prevalent in patients with SCI followed by dermatologic, musculoskeletal and so on. These basic results would be helpful for prevention and management of the complication of SCI.
Academic Medical Centers ; Autonomic Dysreflexia ; Contracture ; Epidemiologic Studies* ; Epidemiology ; Hemorrhoids ; Humans ; Incidence ; Pneumonia ; Pressure Ulcer ; Quality of Life ; Retrospective Studies ; Spinal Cord Injuries* ; Spinal Cord* ; Urinary Tract Infections

OBJECTIVE: The purpose of this study is to present epidemiological data on patients with spinal cord lesion admitted to the Rehabilitation Hospital, YUCM. METHOD: Review of medical records of 590 patients with spinal cord injury admitted to the Rehabilitation Hospital, YUCM from 1987 to 1996 retrospectively. RESULTS: 1) Sex: Males account for 79.6% of the SCI patients. 2) Age: The largest number of injuries occurs in the 20~29 years of age group (32.5% of patients). 3) Etiology: Trauma accounts for 91.2% of all spinal cord injuries. The leading causes of traumatic spinal cord injury are traffic accidents (57.6%) and falls (26.4%). 4) Level of injury: Complete tetraplegia accounts for 20.5% of all SCI patients, incomplete tetraplegia 23.9%, complete paraplegia 38.8% and incomplete paraplegia 16.5%. In tetraplegics, incomplete injuries increased from 40% in 1987~1991 to 56.7% in 1992~1996. 5) Methods of bladder management: 87% of patients voids by reflex. Intermittent catheterization is practiced by 8% of patients. CONCLUSION: Epidemiologic data of 590 patients admitted to the Rehabilitation Hospital, YUCM, from 1987 to 1996 is presented with changes of epidemiology in each period. The patients suffered SCI from trauma, and traffic accidents and sports as causes were increasing. Female patients and incomplete injuries were also increasing. Mean duration of hospitalization decreased.
Accidents, Traffic ; Catheterization ; Catheters ; Epidemiologic Studies* ; Epidemiology ; Female ; Hospitalization ; Humans ; Male ; Medical Records ; Paraplegia ; Quadriplegia ; Reflex ; Rehabilitation ; Retrospective Studies ; Spinal Cord Injuries* ; Spinal Cord* ; Sports ; Urinary Bladder

OBJECTIVE: To provide epidemiologic data of the pressure sores and to determine the most effective prevention and treatment methods. METHOD: Seventy patients with pressure sores who were admitted to the Rehabilitation Hospital, Yonsei University College of Medicine from 1991 to 1995 were included in this study. RESULTS: The average age of the patients was 36. Traffic accident was the most common(46 cases) cause of injury, followed by falling injury. Thirty-one patients developed pressure sores at home, while 39 patients in various hospitals. According to Frankel's classification, 51 cases were Frankel A, 13 cases were Frankel B, 5 cases were Frankel C and none was Frankel D. Sacrum was the most common site of the sore followed by buttock, ischial tuberosity, greater trochanter, and coccyx. Among many factors investigated, the anemia and hypotension had a significant correlation with the healing time. The treatment methods were variable among the patients depending on the size and severity of the sores. The severe and larger lesions required more surgical managements. CONCLUSION: The results support that an intensive prevention is necessary at homes as well as at the hospitals. More educational programs should be provided not only for the patients, but also for the hospital personnels.
Accidents, Traffic ; Anemia ; Buttocks ; Classification ; Coccyx ; Epidemiology* ; Femur ; Humans ; Hypotension ; Personnel, Hospital ; Pressure Ulcer* ; Rehabilitation ; Sacrum ; Spinal Cord Injuries ; Spinal Cord*

PURPOSE: To identify risk factors for developing pressure ulcers (PUs) in the acute care period of traumatic spinal fracture patients with or without spinal cord injuries (SCIs). METHODS: Data were collected prospectively in participating the National Spinal column/Cord Injury Registry of Iran (NSCIR-IR) from individuals with traumatic spinal fractures with or without SCIs, inclusive of the hospital stay from admission to discharge. Trained nursing staff examined the patients for the presence of PUs every 8 h during their hospital stay. The presence and grade of PUs were assessed according to the European Pressure Ulcer Advisory Panel classification. In addition to PU, following data were also extracted from the NSCIR-IR datasets during the period of 2015 - 2021: age, sex, Glasgow coma scale score at admission, having SCIs, marital status, surgery for a spinal fracture, American Spinal Injury Association impairment scale (AIS), urinary incontinence, level of education, admitted center, length of stay in the intensive care unit (ICU), hypertension, respiratory diseases, consumption of cigarettes, diabetes mellitus and length of stay in the hospital. Logistic regression models were used to estimate the unadjusted and adjusted odds ratio (OR) with 95% confidence intervals (CI). RESULTS: Altogether 2785 participants with traumatic spinal fractures were included. Among them, 87 (3.1%) developed PU during their hospital stay and 392 (14.1%) had SCIs. In the SCI population, 63 (16.1%) developed PU during hospital stay. Univariate logistic regression for the whole sample showed that marital status, having SCIs, urinary incontinence, level of education, treating center, number of days in the ICU, age, and Glasgow coma scale score were significant predictors for PUs. However, further analysis by multiple logistic regression only revealed the significant risk factors to be the treating center, marital status, having SCIs, and the number of days in the ICU. For the subgroup of individuals with SCIs, marital status, AIS, urinary incontinence, level of education, the treating center, the number of days in the ICU and the number of days in the hospital were significant predictors for PUs by univariate analysis. After adjustment in the multivariate model, the treating center, marital status (singles vs. marrieds, OR = 3.06, 95% CI: 1.55 - 6.03, p = 0.001), and number of days in the ICU (OR = 1.06, 95% CI: 1.04 - 1.09, p < 0.001) maintained significance. CONCLUSIONS These data confirm that individuals with traumatic spinal fractures and SCIs, especially single young patients who suffer from urinary incontinence, grades A-D by AIS, prolonged ICU stay, and more extended hospitalization are at increased risk for PUs; as a result strategies to minimize PU development need further refinement.
Humans ; Spinal Fractures/etiology* ; Pressure Ulcer/complications* ; Iran/epidemiology* ; Spinal Cord Injuries/epidemiology* ; Risk Factors ; Spine ; Registries ; Urinary Incontinence/complications* ; Suppuration/complications*

OBJECTIVETo analyze the data of patients with spinal cord injury (SCI) induced by road traffic crashes in southeastern Iran for better understanding the pattern of these injuries and therefore for better designing health system planning.

METHODSIn this historical cohort study, the patients who had been transferred to Level I trauma center in southeastern Iran due to road traffic accidents with radiographic documented SCI were evaluated.

RESULTSAmong 64 patients with SCI, 38 patients (59.4%, 36 males and 2 females, aged 27.42 years+/-9.44 years on average) were injured by road traffic accidents. Car and motorcycle accidents were responsible for 26 cases (68.4%) and 12 cases (31.6%), respectively. And 31 patients (81.6%) had complete SCI. Conus medularis (T12-L2) was the most affected level.

CONCLUSIONSResults are discussed in terms of preventive measures, specifically those concerning the use of restraint and helmet and driving behavior. This study should be extended nationally to gain a larger case series so that the SCI risk of particular vehicle configurations, considering other crash factors, can be more precisely quantified and the characteristics for low occurrence of SCI can be more precisely identified.

Accidents, Traffic ; statistics & numerical data ; Adolescent ; Adult ; Equipment Design ; Head Protective Devices ; Humans ; Iran ; epidemiology ; Middle Aged ; Seat Belts ; Spinal Cord Injuries ; epidemiology ; prevention & control ; surgery

A lower risk of prostate cancer has been reported in men with spinal cord injury (SCI) as compared to that observed in able-bodied subjects. As injury-related consequences can have opposite effects on prostate pathophysiology, this meta-analysis aimed to (1) establish the existence/quantify the extent of decreased prostate cancer risk following SCI and (2) find out if there is any statistically significant difference in prostate-specific antigen (PSA) levels between SCI and able-bodied subjects. MEDLINE, Cochrane Library, Scopus, CINAHL, and ScienceDirect databases were used. Only studies reporting a prostate cancer diagnosis and/or PSA levels following SCI and in able-bodied controls were included. Five studies provided information about prostate cancer on 35 293 subjects with SCI and 158 140 controls. Six studies were included in PSA analysis which reported information on 391 men with SCI and 1921 controls. Pooled estimates indicated that SCI reduced the prostate cancer risk by approximately 50% as compared to controls, whereas differences in PSA levels were not statistically significant. Funnel plots suggested the presence of publication bias only in PSA analysis. Between-study heterogeneity was established and when, according to meta-regression models, analysis was restricted to studies including men with mean age over 55 years, prostate cancer risk in SCI decreased up to 65.0% than that in controls with no heterogeneity (P = 0.33, I² = 9%). In conclusion, in men over 55 years old, SCI decreases the prostate cancer risk up to 65.0% than that in controls. The large between-study heterogeneity on PSA confirms its poor reliability as a screening tool for prostate cancer in SCI.
Age Factors ; Aged ; Aged, 80 and over ; Humans ; Male ; Middle Aged ; Prostate-Specific Antigen/analysis* ; Prostatic Neoplasms/epidemiology* ; Risk ; Spinal Cord Injuries/epidemiology*

OBJECTIVE: Patients with hematological malignancies frequently encounter spine-related symptoms, which are caused by disease itself or process of treatment. However, there is still lack of knowledge on their epidemiology and clinical courses. The purpose of this article is to review clinical presentations and surgical results for spinal involvement of hematologic malignancies. METHODS: From January 2011 to September 2014, 195 patients (98 males and 97 females) suffering from hematological malignancies combined with spinal problems were retrospectively analyzed for clinical and radiological characteristics and their clinical results. RESULTS: The most common diagnosis of hematological malignancy was multiple myeloma (96 patients, 49.7%), followed by chronic myeloid leukemia (30, 15.2%), acute myeloid leukemia (22, 11.2%), and lymphoma (15, 7.56%). The major presenting symptoms were mechanical axial pain (132, 67.7%) resulting from pathologic fractures, and followed by radiating pain (49, 25.1%). Progressive neurologic deficits were noted in 15 patients (7.7%), which revealed as cord compression by epidural mass or compressive myelopathy combined with pathologic fractures. Reconstructive surgery for neurologic compromise was done in 16 patients. Even though surgical intervention was useful for early paralysis (Frankel grade D or E), neurologic recovery was not satisfactory for the progressed paralysis (Frankel grade A or B). CONCLUSION: Hematological malignancies may cause various spinal problems related to disease progression or consequences of treatments. Conservative and palliative treatments are mainstay for these lesions. However, timely surgical interventions should be considered for the cases of pathologic fractures with progressive neurologic compromise.
Diagnosis ; Disease Progression ; Epidemiology ; Fractures, Spontaneous ; Hematologic Neoplasms* ; Humans ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive ; Leukemia, Myeloid, Acute ; Lymphoma ; Male ; Multiple Myeloma ; Neurologic Manifestations ; Palliative Care ; Paralysis ; Retrospective Studies ; Spinal Cord Compression ; Spinal Cord Injuries ; Spine