Morbidity and mortality associated with conservative management of spinal cord injury in Makurdi, north central Nigeria

ABSTRACT

Background Spinal cord injury is commonly associated with morbidity and mortality. This is further worsened by inadequate rehabilitation because of dearth of infrastructure, equipment and personnel Objectives:To identify the complications and causes of death in traumatic spinal cord injury patients.Methodology: A 4-year retrospective review of all traumatic spinal cord injured patients treated at Benue State University Teaching Hospital Makurdi was conducted. The information on age, sex, occupation, cause, associated injuries, level of injury, neurological deficit, American spinal cord injury association (ASIA) score at presentation, complications and outcome were obtained from medical records department. Data were analyzed using Statistical Package for Social Sciences (SPSS) 17.0 (SPSS Inc. Chicago, IL, USA).Results: There were 62 patients with a mean age of 36.02±1.67 years (range 8-77 years) consisting of 54 males and 8 females giving a male to female ratio of 6.81. They included students 13(21%) and farmers 10(16.1%). Road traffic crash accounted for 35(56.5%). Majority had cervical spine injury 22(62.8%) and accounted for complications in 20(36.4%). Bed sores occurred in 22(35.5%). ASIA A had the highest frequency of complications 22(35.5%). Eleven patients died giving a case fatality of 31.4%. The patients died from respiratory failure 4(36.4%) and sepsis 2(18.2%). Conclusion: Many complications including bed sores and orthostatic pneumonia result from spinal cord injury leading to high morbidity and death from sepsis and respiratory failure