Mortality Rate and Predicting Factors of Traumatic Thoracolumbar Spinal Cord Injury; A Systematic Review and Meta-Analysis

Abstract

Objective:To estimate the summation of mortality rate and the contributing factors in patients with traumatic thoracolumbar spinal cord injuries (TLSCI). Methods:A systematic search of observational studies that evaluated the mortality associated with TLSCI in MEDLINE and EMBASE was conducted. The study quality was evaluated using a modified quality assessment tool previously designed for observational studies.Results:Twenty-four observational studies involving 11,205 patients were included, published between January 1, 1997, and February 6, 2016. Ten studies were of high quality, thirteen were of moderate quality, and one study was of low quality. Seventeen reports described risk factors for mortality and eleven of these studies used a multiple regression models to adjust for confounders. The reported mortality rate ranged from 0 to 37.7% overall and between 0 and 10.4% in-hospital. The sum of mortality for in-hospital, 6-month, and 12-month were 5.2%, 26.12%, 4.3%, respectively. The mortality at 7.7 years follow-up was 10.07% and for 14 years follow-up reports ranged from 13.47% to 21.46%. Associated data such as age at injury, male to female ratio, pre-existing comorbidities, concomitant injuries, duration of follow-up, and cause of death have been underreported in studies investigating the mortality rate after TLSCI.Conclusion:There is no study was found that accurately assessed mortality in the thoracolumbar spine, while there is general agreement that traumatic thoracolumbar spinal cord injuries are important.

Coenzyme Q10 Regulation of Apoptosis and Oxidative Stress in H2O2 Induced BMSC Death by Modulating the Nrf-2/NQO-1 Signaling Pathway and Its Application in a Model of Spinal Cord Injury

“…However, the survival rate of BMSCs after transplantation is low, as a result of the poor microenvironment produced in SCI, which limits its therapeutic efficiency. In the SCI microenvironment, oxidative stress plays a pivotal role and can lead to cellular damage and even cell apoptosis [36,37]. In our present study, we demonstrate that CoQ10 exerts antioxidative and antiapoptotic effects in H 2 O 2 -induced oxidative injury, which imitates the poor microenvironment of SCI in vitro.…”

The Integrated Transcriptome Bioinformatics Analysis Identifies Key Genes and Cellular Components for Spinal Cord Injury-Related Neuropathic Pain

“…Spinal cord injury, one of the most devastating diseases, disrupts communication between the central and peripheral nervous, leading to the loss of essential neurological functions. Due to a large number of traffic and industrial accidents, the incidence rate of SCI is increasing rapidly around the world (Azarhomayoun et al, 2018;Musubire et al, 2019). Chronic phase of SCI may last a long period after the acute phase, which bring physically and psychologically devastating traumas to persons with SCI (Budh and Osteraker, 2007).…”

“…Therapeutically, there are no effective treatment strategies for SCI-induced neurological deficits, leading to a high disability rate and adding heavy burdens to the individual family and the whole society. In order to bring tangible benefits to patients with SCI, there is a pressing need to explore the pathologic mechanisms which may provide candidate targets for treatment (Azarhomayoun et al, 2018;Musubire et al, 2019).…”

Beyond the Quality of Life in Bowel Dysfunction after Spinal Cord Injury: Approaches to the Consequences in Motility, Immune System, and Microbiome

“…SCI represents a public health problem as it affects the working age population, with a mortality risk two to five times more likely to die prematurely than healthy people; several studies report a mortality rate during the first year after trauma of about 15% [12].…”