Baseline predictors of in-hospital mortality after acute traumatic spinal cord injury: data from a level I trauma center.

Death Hospital Mortality Humans Retrospective Studies Spinal Cord Injuries Trauma Centers

Journal

Scientific reports
ISSN: 2045-2322
Titre abrégé: Sci Rep
Pays: England
ID NLM: 101563288

Informations de publication

Date de publication:
06 07 2022
Historique:
received: 10 01 2022
accepted: 24 06 2022
entrez: 6 7 2022
pubmed: 7 7 2022
medline: 9 7 2022
Statut: epublish

Résumé

Comorbidity scores are important predictors of in-hospital mortality after traumatic spinal cord injury (tSCI), but the impact of specific pre-existing diseases is unknown. This retrospective cohort study aims at identifying relevant comorbidities and explores the influence of end-of-life decisions. In-hospital mortality of all patients admitted to the study center after acute tSCI from 2011 to 2017 was assessed. A conditional inference tree analysis including baseline data, injury characteristics, and Charlson Comorbidity Index items was used to identify crucial predictors. End-of-life decisions were recorded. Three-hundred-twenty-one patients were consecutively enrolled. The median length of stay was 95.7 days (IQR 56.8-156.0). During inpatient care, 20 patients (6.2%) died. These patients were older (median: 79.0 (IQR 74.7-83.2) vs. 55.5 (IQR 41.4-72.3) years) and had a higher Charlson Comorbidity Index score (median: 4.0 (IQR 1.75-5.50) vs. 0.0 (IQR 0.00-1.00)) compared to survivors. Pre-existing kidney or liver disease were identified as relevant predictors of in-hospital mortality. End-of-life decisions were observed in 14 (70.0%) cases. The identified impairment of kidney and liver, important for drug metabolism and elimination, points to the need of careful decisions on pharmaceutical treatment regimens after tSCI. Appropriate reporting of end-of-life decisions is required for upcoming studies.

Identifiants

DOI: 10.1038/s41598-022-15469-z PMID: 35794189 PMC: PMC9259676
pubmed: 35794189
doi: 10.1038/s41598-022-15469-z
pii: 10.1038/s41598-022-15469-z
pmc: PMC9259676
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

11420

Informations de copyright

© 2022. The Author(s).

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Auteurs

Christian Blex (C)

Clinical and Experimental Spinal Cord Injury Research (Neuroparaplegiology), Department of Neurology With Experimental Neurology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Charitéplatz 1, 10117, Berlin, Germany. christian.blex@charite.de.
QUEST-Center for Transforming Biomedical Research, Berlin Institute of Health (BIH), Anna-Louisa-Karsch-Str. 2, 10178, Berlin, Germany. christian.blex@charite.de.

Martin Kreutzträger (M)

Treatment Center for Spinal Cord Injuries, Trauma Hospital Berlin, Warener Str. 7, 12683, Berlin, Germany.

Johanna Ludwig (J)

Treatment Center for Spinal Cord Injuries, Trauma Hospital Berlin, Warener Str. 7, 12683, Berlin, Germany.
Clinic for Trauma Surgery and Orthopedics, Trauma Hospital Berlin, Warener Str. 7, 12683, Berlin, Germany.

Claus Peter Nowak (CP)

Institute of Biometry and Clinical Epidemiology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Charitéplatz 1, 10117, Berlin, Germany.
Berlin Institute of Health (BIH), Anna-Louisa-Karsch-Str. 2, 10178, Berlin, Germany.

Jan M Schwab (JM)

Clinical and Experimental Spinal Cord Injury Research (Neuroparaplegiology), Department of Neurology With Experimental Neurology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Charitéplatz 1, 10117, Berlin, Germany.
Spinal Cord Injury Medicine (Neuroparaplegiology), Department of Neurology, The Ohio State University, Wexner Medical Center, Columbus, OH, USA.
Belford Center for Spinal Cord Injury, Departments of Neuroscience and Physical Medicine and Rehabilitation, The Neurological Institute, The Ohio State University, Wexner Medical Center, Columbus, OH, USA.

Tom Lübstorf (T)

Clinical and Experimental Spinal Cord Injury Research (Neuroparaplegiology), Department of Neurology With Experimental Neurology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Charitéplatz 1, 10117, Berlin, Germany.

Axel Ekkernkamp (A)

Clinic for Trauma Surgery and Orthopedics, Trauma Hospital Berlin, Warener Str. 7, 12683, Berlin, Germany.
Department of Traumatology, University of Greifswald, Sauerbruchstraße, 17491, Greifswald, Germany.

Marcel A Kopp (MA)

Clinical and Experimental Spinal Cord Injury Research (Neuroparaplegiology), Department of Neurology With Experimental Neurology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Charitéplatz 1, 10117, Berlin, Germany. marcel.kopp@charite.de.
QUEST-Center for Transforming Biomedical Research, Berlin Institute of Health (BIH), Anna-Louisa-Karsch-Str. 2, 10178, Berlin, Germany. marcel.kopp@charite.de.

Thomas Liebscher (T)

Clinical and Experimental Spinal Cord Injury Research (Neuroparaplegiology), Department of Neurology With Experimental Neurology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Charitéplatz 1, 10117, Berlin, Germany.
Treatment Center for Spinal Cord Injuries, Trauma Hospital Berlin, Warener Str. 7, 12683, Berlin, Germany.

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questionsmedicales.fr › Administration des services de santé › Organisation et administration › Administration d'établissement de santé › Administration hospitalière › Services hospitaliers › Service hospitalier d'urgences › Centres de traumatologie › Baseline predictors of in-hospital mortality...