TY  - JOUR
PY  - 2017//
TI  - The burden of spine fractures in India: a prospective multicenter study
JO  - Global spine journal
A1  - Aleem, Ilyas S.
A1  - DeMarco, Dylan
A1  - Drew, Brian
A1  - Sancheti, Parag
A1  - Shetty, Vijay
A1  - Dhillon, Mandeep
A1  - Foote, Clary J.
A1  - Bhandari, Mohit
SP  - 325
EP  - 333
VL  - 7
IS  - 4
N2  - STUDY DESIGN: Prospective cohort study. <br><br>OBJECTIVES: The objectives of this study were (1) to determine the characteristics of patients sustaining spinal trauma in India and (2) to explore the association between patient or injury characteristics and outcomes after spinal trauma. <br><br>METHODS: In affiliation with the ongoing INternational ORthopaedic MUlticentre Study (INORMUS), 192 patients with spinal injuries were recruited during an 8-week period (November 2011 to June 2012) from 14 hospitals in India and followed for 30-days. The primary outcome was a composite of mortality, complications, and reoperation. This was regressed on a set of 13 predictors in a multiple logistic regression model. <br><br>RESULTS: Most patients were middle-aged (mean age = 51.0 years; median age = 55.5 years; range = 18.0 to 72.0 years), male (60.4%), injured from falls (72.4%), and treated in a private setting (59.9%). Fractures in the lumbar region (51.0%) were most common, followed by thoracic (30.7%) and cervical (18.2%). More than 1 in 5 (21.6%) patients experienced a treatment delay greater than 24 hours, and 36.5% arrived by ambulance. Thirty-day mortality and complication rates were 2.6% and 10.0%, respectively. Care in the public hospital system (odds ratio [OR] = 6.7, 95% CI = 1.1-41.6), chest injury (OR = 11.1, 95% CI = 1.8-66.9), and surgical intervention (OR = 4.8, 95% CI = 1.2-19.6) were independent predictors of major complications. <br><br>CONCLUSIONS: Treatment in the public health care system, increased severity of injury, and surgical intervention were associated with increased risk of major complications following spinal trauma. The need for a large-scale, prospective, multicenter study taking into account spinal stability and neurologic status is feasible and warranted.<p />  <p>Language: en</p>
LA  - en
SN  - 2192-5682
UR  - http://dx.doi.org/10.1177/2192568217694362
ID  - ref1
ER  -