Outcome of the spinal injured patients at the first spinal injury unit in Thailand.

ABSTRACT

The first Spinal Injury Unit in Thailand was established at Siriraj Hospital, Mahidol University, Bangkok, Thailand. There is an extensive acute clinical database program in place for the acute care section as well as active database collection in progress for the acute rehabilitation section. The information presented in this paper represents management and outcome statistics compiled from the medical records of all 150 patients who were admitted to the Siriraj Spinal Injury Unit for acute spinal injuries between Frbruary,1995, and December,1996. The survey group included 90 males and 60 females, ranging in age from 2 to 70 with a mean age 34.4 years of age for the entire group. After data was compiled for the entire survey group, analysis revealed that traffic accidents (cars and motorcycles) were the primary cause of injury (69.3% of the cases) followed by injuries due to falls (17.3% of the cases). The injuries were further classified according to the site or level of injury, with cervical injuries leading the list, comprising 50% of the injuries. An investigation into the degree of neurological deficit was also made, with the incidence of complete neurological deficit occurring in 38% of all cases studied. Associated problems for the subjects included urinary tract infection(22.1%), muscle spasm and pain(12.2%), gastric ulcers(9.1%), pressure sores(7.6%) and psychological problems(3.0%). Patients with complete neurological deficit required longer hospitazation than those with incomplete neurological deficit for recovery. This also reflected in the average cost for hospitazation $1,800 per patient for cases involving complete neurological deficit, $1,500 for those with incomplete lesion, and $520 for those without neurological deficit. The research conducted for this study using a clinical database collection program enables medical personal to provide more precise information about the course of treatment for patients admitted for spinal injuries. Most importantly, it enables medical personal to plan and prepare for treatment of patients admitted for spinal injury in a more systematic manner to promote more successful treatment for mutual benefit of doctors as well as their patients.