Clinical aspects of patients with spinal cord injury in public and private hospitals in São Luis, Maranhão

THESES

Clinical aspects of patients with spinal cord injury in public and private hospitals in São Luis, Maranhão (Abstract)^*. Dissertation. São Luís, 2006.

Osmir de Cássia Sampaio^**

INTRODUCTION: Traumatic Spinal Cord Injury (SCI) is one of the important causes of the morbidity and mortality. In Maranhão, there are no records of epidemiological study regarding frequency and profiles of SCI patients.

OBJECTIVE: To supply data about the clinical characteristics of SCI in Maranhão.

METHOD: A prospective study was conducted on 59 SCI patients that were hospitalized in 3 public establishments and a private one in São Luís-MA, between the months of April/2003 and March/2004. All patients were object of neurological evaluation (inspection, touchstone of the cervical-dorsal-lombar region), sensibility tests (touch, thermal, painful, and vibrating),and were registered in a specific record. Regarding the test to evaluate the importance of the damage, the ASIA table (Frankel) was used. 34 SCI patients from the countryside and from the capital of Maranhão were analyzed. The studies of 3 patients were excluded because families chose to treat their patients in establishments where this study was not conducted, and a patient was transferred to be treated at home. The qui-square (c²) test was applied, and the contingency table and level of reaction to the hypothesis of nullity was established in 5%. (p< 0.05).

RESULTS: During this study, it was noticed that the majority of the patients were from the countryside of Maranhão (58.3%), were mainly men (77.9% were men, whereas 22.1% were women). Most of the patients were between the ages of 13-30 (54.2%), specially between the ages of 13-20 (23.7%). Considering the occupation of the patients, it was noticed that the majority was composed of plantation workers. The most common causes of SCI were: fall (47.4%), and automobilist accident (28.11%). The majority of the patients were married (64.4% were married, whereas 33.9% were single). The segment of the backbone that was damaged were, respectively, the dorsal (41.47%), and cervical (40%). Considering the length of time between the accident and the diagnosis, it was, in average, 9-24 h. There were found 51.7% of incomplete damages, whereas 48.3% of the damages were complete. 86.4% of the patients went through surgery, and 66% of those were object of XR, CT and MRI. Some complications were noticed, such as post-surgery problems (81%). There was also the occurrence of urine infection (31%),and skin/urine infection (43.2%). Concerning the distribution in relation to the patients gender and degree of damage, there were found 65.2% of men with complete damage and 50% of women with normal neurological exam (Frankel E). These results were significant (p=0.010). This distribution of prevailing according to gender and damaged backbone segment supplied significant results in the relation of cervical and men (47.8%), and lombar and women (46.2%).

CONCLUSION: It was concluded that the traumatic spinal cord injury patients in the State of Maranhão, are men, married, victims of fall, that were diagnosed 9-24 hours after the accident. The dorsal segment presented most of the damages, specially Frankel A. In the surgery treatment the access way was, mainly, the posterior one. Urine infection present most of the cases of complications.

Key Words: spinal cord injury, trauma, epidemiology, prevention.

*

Aspectos clínicos do traumatizado raquimedular atendidos em hospitais públicos e privados em São Luís - Maranhão (Resumo). Dissertação de Mestrado, Universidade Federal do Maranhão (Área: Ciências da Saúde). Orientador: Orlando Jorge Martins Torres.

**

Address: Avenida Holandeses Q 31 n 07 / 3º andar, 65071-380 São Luís MA, Brasil.

Publication Dates

• Publication in this collection
  02 Aug 2006
• Date of issue
  June 2006