■火器相关性脊髓损伤(SCI)的手术治疗仍然存在争议,没有明确的指导方针。手术时间到了,手术适应症,和病人的特点在这一组的初始表现是不清楚的,这些因素可能会影响手术干预后神经功能恢复的潜力。
■了解枪支相关SCI后手术干预的时机和影响因素。
■在一项回顾性队列研究中,2012年7月至2022年7月的创伤性SCI患者(n=1569)来自我们的1级创伤中心创伤登记处.数据来自创伤登记和图表审查。手术干预的速度和时机,初始伤害严重程度测量,比较了火器相关性SCI和钝性损伤SCI的一般医院结局。
■与其他病因相比,枪支相关性SCI患者接受手术的可能性较小(24.3%vs.70.2%,P<0.0001)。枪支相关SCI的手术时间比其他病因更长(49.2±92.9vs.30.6h±46.0,P=0.012)。初始伤害严重程度的多种测量,包括伤害严重程度评分,格拉斯哥昏迷评分,在枪支相关性SCI患者中,急诊科处置显示损伤更严重,这些患者在脊柱手术前通常需要其他紧急手术(52%).
■与钝性创伤SCI相比,火器相关性SCI患者的脊柱手术时间更长,火器相关性SCI患者在初次就诊时受伤更严重。需要进一步的研究来了解患者受伤严重程度之间的复杂关系,手术干预,手术时机,以及枪支相关SCI后的结果。
UNASSIGNED: Surgical management of firearm-related spinal cord injury (SCI) remains controversial, and there are no clear guidelines. Time to surgery, surgical indications, and patient characteristics on initial presentation in this group are not well understood, and these factors may impact the potential for neurologic recovery after operative intervention.
UNASSIGNED: To understand the timing and factors affecting the timing of operative intervention after firearm-related SCI.
UNASSIGNED: In a retrospective cohort study, patients with traumatic SCI from July 2012 to July 2022 (n = 1569) were identified from our level 1 trauma center Trauma Registry. Data was obtained from the trauma registry and chart review. Rates and timing of surgical intervention, initial injury severity measures, and general hospital outcomes were compared between firearm-related SCI and blunt trauma SCI.
UNASSIGNED: Patients with firearm-related SCI were less likely to undergo surgery compared to other etiologies (24.3% vs. 70.2%, P < 0.0001). Time to surgery for firearm-related SCI was longer than for other etiologies (49.2 ± 92.9 vs. 30.6 h ± 46.0, P = 0.012). Multiple measures of initial injury severity, including Injury Severity Score, Glasgow Coma Score, and emergency department disposition demonstrated more severe injury among patients with firearm-related SCI, and these patients often required other emergent surgeries prior to spine surgery (52%).
UNASSIGNED: There was a longer time to spine surgery among patients with firearm-related SCI compared to blunt trauma SCI, and patients with firearm-related SCI were more severely injured on initial presentation. Further research is needed to understand the complex relationship between patient injury severity, surgical intervention, surgical timing, and outcomes after firearm-related SCI.