Characteristics of Wenchuan earthquake patients with spinal injuries / 中华创伤杂志

ABSTRACT

Objective To investigate the characteristics of spinal injury caused by earthquake as well as to improve its therapeutic ability by comparatively studying the medical records of the inpatients with spinal injuries caused by Wenchuan earthquake and the inpatients with spinal injuries in peace time.Methods Medical records of inpatients with spinal injuries were extracted from 5.12 earthquake injury database(earthquake group) and medical records of the patients with spinal injuries firstly admitted to Daping Hospital between 2001 and 2007 were extracted from Chinese trauma database systems (control group).The epidemiological characteristics of the two groups were comparatively studied,including gender,age,injury causes,injury severity,treatments and outcomes.Results (1) The incidence of spinal injuries in the earthquake group was 16.7％ (524/3145),which was significantly higher than that (6.4％,682/10644) in control group (P＜0.01).(2) The female ratio in the earthquake group was significantly higher than that in the control group (57.4％31.8％) (P＜0.01).(3) The age range of the earthquake group was (47.9 ±20.9) years.The wounded number presented an undulately rising trend in the earthquake group as the growth of age,while it showed a parabolic distribution in the control group.(4)The main causes for spinal injuries were crush injury (69.3％) and multi-factor injury (2.8％) in the earthquake group,while slipping up/fall (56.0％) and traffic accidents (23.6％) were the main causes in the control group.(5) There were 82.3％ of the earthquake group that were combined with multiple injuries and 48.1％ combined with at least two injuries,while the control group accounted for only 28.9％ and 12.0％ respectively.The NISS (new injury severity score) in the earthquake group was significantly higher than that in the control group [(11.6±8.8) points vs (7.5±4.8)points](P＜0.01).Meanwhile,the proportion of NISS≥16 in earthquake group was significantly higher than that in the control group as well (P＜0.01).(6) The length of hospital stay of the wounded in the earthquake group was significantly longer than that in control group [(40.5±24.5)d VS (23.9±26.7)d](P＜0.01).The treatment inefficiency rate in the earthquake group was higher than that in the control group (9.2％ vs 4.8％) (P＜0.01).Conclusions The earthquake group has a higher proportion of spinal injuries,female and elder cases,and combined injuries,a much severer injury,a longer length of hospital stay,and a higher treatment inefficiency rate,as compared with the control group.In the earthquake relief,more importance should be attached to salvage,diagnosis,transfer regulation and missed diagnosis,misdiagnosis and secondary injury should be avoided so as to improve the treatment level of the spinal injuries in earthquake.