| 【Objective】This study aimed to explore the epidemiological characteristics and clinical features,the current treatment status and economic burden of traumatic cervical spinal cord injury(TCSCI)in 37 hospitals in China between 2013-2018.【Method】The medical records of TCSCI were obtained from 37 hospitals from China between 2013 and 2018.Variables were recorded,including gender,age,occupation,etiology,the level of injury,American Spinal Injury Association Impairment Scale(AIS),complication,hospitalization date,time from injury to surgery and pharmacological treatment,dosage and hospitalization expenses.10% cases were randomly selected by senior orthopaedic doctors in Tianjin Medica0 l University General Hospital to test the consistency.After strictly checking the raw data,the data were input into Microsoft Excel and analyzed with SPSS software statistically.【Result】1.Epidemiological and Clinical Features of TCSCI: A total of 9030 patients were recruited,the male-to-female ratio was 3.86:1,the mean age was 51.67 years.The greatest frequency was found among those aged 45-54 years(28.9%).More than 70% patients were aged ≥45 years.TCSCI patients were more likely to be farmers and workers.The top 3 etiology were low falls,traffic accidents and high falls.TCSCI occurred mostly in C4-C6(67.3%).More than half were AIS D grades(50.9%).Respiratory,hematologic and urinary were the most common complications.The mean length of stay was 19.07 days.From 2013 to 2018,the TCSCI patients increased significantly by 7.4%.The percentage of patients aged≥65 years increased by 12.2%,while patients aged 15-24 years decreased by15.0%.2.Treatment status of TCSCI: A total of 6408(71.0%)patients received surgery after TCSCI.Only 125(2.0%)patients received within 24 hours.The lowest percentage of surgery within 24 hours was in: patients aged ≥65 years,low falls and AIS D,while the highest was in: 25-34 years,struck by falling objects and AIS A grade.1407 patients were treated with methylprednisolone sodium succinate(MPSS)at a high dose(≥500 mg),among them 400 patients(28.4%)received in less than 8 hours.3706 patients were treated with MPSS at a normal dose of MPSS(<500 mg).1876 patients received dexamethasone and 228 patients received hydrocortisone in normal dose.In addition,more than two thirds of patients(6215,68.8%)received neurotrophic drugs,5814 patients(64.4%)were treated by dehydrants and 762 patients(8.4%)received cathartics.3.Economic Burden of TCSCI: The mean total costs of TCSCI patients were Chinese Yuan(CNY,￥)72.0k,with daily costs of ￥4.6k.The lowest total costs were found in patients aged ≥65 years,while the highest was in 25-34 years.Total costs were highest in drivers and workers in occupation.Struck by falling objects,high falls and traffic accidents were top 3 etiologies in total and daily costs.AIS A and B grades were highest in daily costs.From 2013 to 2018,the total costs increased insignificantly,while the daily costs increased significantly by 3.4% annually.The daily costs increased significantly in 35-44 years,55-64 years and patients aged ≥65 years.【Conclusion】1.This study revealed the epidemiological features and trends of TCSCI in 37 hospitals in China from 2013 to 2018,which provided a theoretical basis for the improvement of preventive measures for TCSCI.2.The treatment status about surgery,corticosteroids,neurotrophic drugs,dehydrants and cathartics in TCSCI was described in this study,which indicated that hospitals should improve the relevant rapid diagnosis and treatment system to simplify the early treatment path of TCSCI.3.The hospitalization costs and trends of TCSCI from 2013 to 2018 was analyzed in this study,which is of great significance to the improvement and optimization of social welfare policies such as medical insurance. |
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