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首页> 外文期刊>Prehospital emergency care >Prehospital Predictors of Traumatic Spinal Cord Injury in Victoria, Australia
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Prehospital Predictors of Traumatic Spinal Cord Injury in Victoria, Australia

机译：维多利亚，澳大利亚创伤脊髓损伤的预孢子预测因子

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Objectives: To identify the predictors of traumatic spinal cord injury (TSCI) and describe the differences between confirmed and potential TSCI cases in the prehospital setting. Methods: A retrospective cohort study including all adult patients over a six-year period (2007-12) with potential TSCI who were attended and transported by Ambulance Victoria (AV). We extracted potential TSCI cases from the AV data warehouse and linked with the Victorian State Trauma Registry to compare with final hospital diagnosis. Results: We included a total of 106,059 patients with potential TSCI in the study, with 257 having a spinal cord injury confirmed at hospital (0.2%). The median [First and third Quartiles] age of confirmed TSCI cases was 49 [32-69] years, with males comprising 84.1%. Confirmed TSCI were mainly due to falls (44.8%) and traffic incidents (40.5%). AV spinal care guidelines had a sensitivity of 100% to detect confirmed TSCI. There were several factors associated with a diagnosis of TSCI. These were meeting AV Potential Major Trauma criteria, male gender, presence of neurological deficit, presence of an altered state of consciousness, high falls (> 3meters), diving, or motorcycle or bicycle collisions. Conclusion: This study identified several predictors of TSCI including meeting AV Potential Major Trauma criteria, male gender, presence of neurological deficit, presence of an altered state of consciousness, high falls (> 3meters), diving, or motorcycle or bicycle collisions. Most of these predictors are included in NEXUS and/or CCR criteria, however, Potential Major Trauma criteria have not previously been linked to the presence of TSCI. Therefore, Emergency Medical Systems are encouraged to integrate similar Potential Major Trauma criteria into their guidelines and protocols to further improve the provider's accuracy in identifying TSCI and to be more selective in their spinal immobilization, thereby reducing unwarranted adverse effects of this practice.
机译：目的：鉴定创伤性脊髓损伤（TSCI）的预测因子，并描述在预孢子环境中确认和潜在的TSCI病例之间的差异。方法：一种回顾性队列研究，包括六年（2007-12）的所有成年患者，潜在的TSCI被救护车（AV）参加和运输。我们从AV数据仓库中提取了潜在的TSCI案例，并与维多利亚时代的国家创伤登记处联系，与最终医院诊断进行比较。结果：我们在研究中占总潜在的TSCI患者总共106,059名患者，257例在医院确诊脊髓损伤（0.2％）。确诊的TSCI病例的中位数[第三个和第三个四分位数]年龄为49岁，雄性包含84.1％。确认的TSCI主要是由于跌倒（44.8％）和交通事故（40.5％）。 AV脊柱护理指南的敏感性为100％以检测确认的TSCI。有几个因素与TSCI的诊断相关。这些正在达到AV潜在的主要创伤标准，男性性别，神经缺陷的存在，发生改变的意识状态，高瀑布（> 3米），潜水或摩托车或自行车碰撞。结论：本研究确定了TSCI的几个预测因素，包括举行AV潜在的主要创伤标准，男性性别，神经缺陷的存在，发生改变的意识状态，高瀑布（> 3米），潜水或摩托车或自行车碰撞。这些预测因子中的大多数包括在Nexus和/或CCR标准中，然而，潜在的主要创伤标准以前没有与TSCI的存在相关联。因此，鼓励紧急医疗系统将类似的潜在主要创伤标准整合到他们的准则和协议中，以进一步提高提供者在识别TSCI方面的准确性，并在其脊柱固定中更具选择性，从而减少了对这种做法的不利影响。

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