The Study On Disease Spectrum And Risk Factors Of Early Complications Of Traumatic Spinal Cord Injury

【Objective】The purpose of this study is to explore the disease spectrum and incidence of early complications during the first hospitalization of traumatic spinal cord injury(TSCI),and to analyze the risk factors that affect the occurrence of complications,so as to provide theoretical basis for the prevention strategy of early complications of TSCI.【Method】The disease spectrum and incidence of early complications after TSCI in the sample population were statistically analyzed.According to gender,age group,injury segment and severity,the disease spectrum of complications was constructed.The factors that may affect the occurrence of complications of TSCI were analyzed by chi-square test and t-test,and the incidence of complications in the sample population was compared with that in the control group.The distribution of risk factors such as demographic characteristics,past medical history and clinical characteristics among the groups without complications was different Regression analysis of the ratio of each relevant factor to the incidence of complications after TSCI.In the process of analysis,all possible factors were adjusted to determine the risk factors that may be related to the occurrence of complications.Gender and age stratified analysis of the relevant factors was carried out to explore the differences of risk factors of complications in different age and gender sample population.【Results】In this study,6127 patients aged 15 years and over were admitted to 13 hospitals for the first time between 2013 and 2018,including 4755(77.6%)males and 1372(22.4%)females.The overall incidence of complications was 24.7%.Among the complications,the highest incidence rate of pulmonary infection(658 cases)was observed and according to the system of complications,the disease spectrum of patients with different gender,age group,injury segment and severity was different.The results of multivariate analysis showed that age was the risk factor of complications after TSCI.Compared with 15-29 years old patients,the risk of complications increased with the increase of age(P < 0.05);in male patients,≥ 75 years old was the risk factor of complications;in female patients,≥ 60 years old was the risk factor of complications.In both male and female patients,previous smoking history was the risk factor of complications after TSCI(P < 0.05);in patients younger than 60 years,smoking history increased the risk of complications(P < 0.05),while in patients older than 60 years,smoking history was not the risk factor of complications(P > 0.05).No matter in male and female groups,or in the middle-aged,young and old people,basic complications increased the risk of complications(P <0.05);compared with rural household registration,urban household registration was the protective factor of complications after TSCI(P < 0.05);Compared with the causes of low-energy injury,the causes of high-energy injury increased the risk of complications(P < 0.05);compared with cervical spinal cord injury,lumbosacral spinal cord injury increased the risk of complications(P < 0.05),but there was no statistical difference between thoracic spinal cord injury and cervical spinal cord injury(P > 0.05);compared with Asia D,the high level of Asia score increased the risk of complications(P < 0.05).There was no significant correlation between sex,residence,occupation,combined injury,operation and hormone and complications(P > 0.05).【Conclusions】This study is a retrospective study based on the medical records of TSCI patients in 13 representative hospitals of different levels in 4 provinces of China from 2013 to2018.The results showed that the overall incidence of early complications in patients with TSCI was 24.7%.The disease spectrum of complications was constructed,and different gender,age group,injury segment and severe patients had different disease spectrum of complications.In the study population,age,household registration(rural/ urban),smoking history,high-energy injury,comorbidities,injury segments,and Asia scores were risk factors for complications.However,there were differences in the effects of gender and age groups on complications.Therefore,individual prevention measures should be put forward for patients of different ages and genders,especially for the elderly,to control the risk factors and reduce the burden of complications after TSCI.