Spinal cord injury (SCI)—Prehospital management

Bernhard, Michaël; Gries, A.; Kremer, P.; Böttiger, Bernd W.

doi:10.1016/j.resuscitation.2005.03.005

Cited by 107 publications

(62 citation statements)

References 55 publications

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“…The annual incidence of SCI is up to 40 cases per million in the United States. 1 In Iran, as a developing country, SCI relatively common and estimated 4.4 per 100 000. 2 Health care and life expenditures due to SCI are about $200 000 during the first 2 years after injury.…”

Section: Introductionmentioning

confidence: 99%

“…2 In addition, patents with SCI are more likely to suffer from impaired bladder and bowel control, fatigue and musculoskeletal pain. 1 Efforts are now directed to help patients with SCI to live productive lives and experience a normal life expectancy. However, studies have found that patients with SCI suffer from sexual dysfunction and this is true for both sexes depending on the level of injury.…”

Section: Introductionmentioning

confidence: 99%

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Female sexual dysfunction in patients with spinal cord injury: a study from Iran

et al. 2014

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Objectives: We assess the prevalence of sexual dysfunction in patients with spinal cord injury (SCI), compare sexual function and sexual distress between female patients with SCI and gender-matched healthy controls, and address risk factors associated with sexual dysfunction among Iranian female patients with SCI. Setting: Brain and Spinal Cord Injury Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran. Methods: Eligible Iranian female patients with SCI were included in this cross-sectional study. They were asked to provide sociodemographic information, and complete the Female Sexual Function Index, Hospital Anxiety and Depression Scale and Female Sexual Distress Scale-Revised questionnaire. Results: Of the 105 patients participated in this study, the average age was 41.0 (s.d. ¼ 10.1) years. Women with SCI reported significantly higher levels of sexual dysfunction compared with normal controls. Approximately, 88% of SCI patients reported at least one type of sexual dysfunction, whereas only 37% of healthy controls reported sexual dysfunction. Lack of vaginal lubrication was reported more frequent in SCI patients compared with controls. Women with SCI reported a significantly higher level of sexual distress compared with healthy women. Sexual dysfunction was observed to be significantly higher in older patients, those with less education, patients with complete lesions, those with sexual distress and patients who were anxious and depressed. Conclusion: Sexual dysfunction is highly prevalent among Iranian women with SCI. Sexual dysfunction is associated with age, education, symptoms of depression and anxiety and level of injury. Sexual counseling during the rehabilitation period may help to prevent sexual dysfunction following SCI.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Female sexual dysfunction in patients with spinal cord injury: a study from Iran

et al. 2014

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“…It is one thing, however, to appreciate and acknowledge 'practice guidelines' and 'recommendations' , and quite another to actually translate and implement these effectively in patients. Despite the fact that numerous reviews have been conducted on the topic of MAP support in acute SCI, [10][11][12] to our knowledge, there are no published reports that specifically evaluate how successfully target MAPs were maintained in acute SCI patients. Therefore, the purpose of this study was to evaluate the observed MAP in a cohort of prospectively evaluated acute SCI patients, in order to determine how closely the intended MAP was actually achieved in these individuals.…”

Section: Introductionmentioning

confidence: 99%

A prospective evaluation of hemodynamic management in acute spinal cord injury patients

et al. 2013

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Study design: Prospective observational study of acute spinal cord-injured (SCI) patients. Objectives: To determine how effectively mean arterial blood pressure (MAP) and spinal cord perfusion pressure (SCPP) are maintained at target levels in acute SCI patients. Setting: Single-institution study at a Canadian level-one trauma center. Methods: Twenty-one individuals with cervical or thoracic SCI were enrolled within 48 h of injury. A lumbar intrathecal drain was inserted for monitoring intrathecal cerebrospinal fluid pressure (ITP). The MAP was monitored concurrently with ITP, and the SCPP was calculated. Data was recorded hourly from the time of first assessment until at least the end of the 5th day post injury. Results: All subjects had at least one recorded episode with a MAP below 80 mm Hg, and 81% had at least one episode with a MAP below 70 mm Hg. On average, subjects with cervical injuries had 18.4% of their pressure recordings below 80 mm Hg. Subjects with thoracic cord injuries had on average 35.9% of their MAP recordings o80 mm Hg. Conclusion: It is common practice to establish MAP targets for optimizing cord perfusion in acute SCI. This study suggests that even in an acute SCI referral center, when prospectively scrutinized, the actual MAP may frequently fall below the intended targets. Such results raise awareness of the vigilance that must be kept in the hemodynamic management of these patients, and the potential discrepancy between routinely setting target MAP according to 'practice guidelines' and actually achieving them.

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“…1,2 Acute TSCI management starts at the scene of trauma, with the aim of limiting the extent of injury, handling its acute consequences, and preventing complications. 3 Managing TSCI in spinal injury units (SIUs) as compared with fragmented care in general health-care facilities has been shown to be of benefit.…”

Section: Introductionmentioning

confidence: 99%

Acute management of traumatic spinal cord injury in a Greek and a Swedish region: a prospective, population-based study

2009

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Study design: Prospective, population-based study. This paper is part of the Stockholm Thessaloniki Acute Traumatic Spinal Cord Injury Study (STATSCIS). Objectives: To characterize patient populations and to compare acute management after traumatic spinal cord injury (TSCI). Settings: The Greater Thessaloniki region in Greece and the Greater Stockholm region in Sweden. Methods: Inception cohorts with acute TSCI that were hospitalized during the study period, that is September 2006 to October 2007, were identified. Overall, 81 out of 87 cases consented to inclusion in Thessaloniki and 47 out of 49 in Stockholm. Data from Thessaloniki were collected through physical examinations, medical record reviews and communication with TSCI cases and medical teams. Data from Stockholm were retrieved from the Nordic Spinal Cord Injury Registry. Results: There were no significant differences between study groups with regard to core clinical characteristics. In contrast, there were significant differences in (1) transfer logistics from the scene of trauma to a tertiary-level hospital (number of intermediate admissions, modes of transportation and duration of transfer) and (2) acute key therapeutic interventions, that is, the use of mechanical ventilation (49% in Thessaloniki versus 20% in Stockholm), and performance of tracheostomy (36% in Thessaloniki versus 15% in Stockholm); spinal surgery was performed significantly more often and earlier in Stockholm than in Thessaloniki. Conclusions: Despite largely similar core clinical characteristics, Stockholm and Thessaloniki cases underwent significantly different acute management, most probably to be attributed to adaptations to the differing regional approaches of care one following a systematic approach of SCI care and the other not.

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Spinal cord injury (SCI)—Prehospital management

Cited by 107 publications

References 55 publications

Female sexual dysfunction in patients with spinal cord injury: a study from Iran

Female sexual dysfunction in patients with spinal cord injury: a study from Iran

A prospective evaluation of hemodynamic management in acute spinal cord injury patients

Acute management of traumatic spinal cord injury in a Greek and a Swedish region: a prospective, population-based study

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