TY  - JOUR
PY  - 2020//
TI  - Epidemiology of traumatic spinal cord injury in the Netherlands: emergency medical service, hospital, and functional outcomes
JO  - Topics in spinal cord injury rehabilitation
A1  - Niemeyer, Menco J. S.
A1  - Lokerman, R. D.
A1  - Sadiqi, S.
A1  - van Heijl, M.
A1  - Houwert, R. M.
A1  - van Wessem, K. J. P.
A1  - Post, M. W. M.
A1  - van Koppenhagen, C. F.
SP  - 243
EP  - 252
VL  - 26
IS  - 4
N2  - BACKGROUND: Evaluating treatment of traumatic spinal cord injuries (TSCIs) from the prehospital phase until postrehabilitation is crucial to improve outcomes of future TSCI patients. <br><br>OBJECTIVE: To describe the flow of patients with TSCI through the prehospital, hospital, and rehabilitation settings and to relate treatment outcomes to emergency medical services (EMS) transport locations and surgery timing. <br><br>METHOD: Consecutive TSCI admissions to a level I trauma center (L1TC) in the Netherlands between 2015 and 2018 were retrospectively identified. Corresponding EMS, hospital, and rehabilitation records were assessed. <br><br>RESULTS: A total of 151 patients were included. Their median age was 58 (IQR 37-72) years, with the majority being male (68%) and suffering from cervical spine injuries (75%). In total, 66.2% of the patients with TSCI symptoms were transported directly to an L1TC, and 30.5% were secondarily transferred in from a lower level trauma center. Most injuries were due to falls (63.0%) and traffic accidents (31.1%), mainly bicycle-related. Most patients showed stable vital signs in the ambulance and the emergency department. After hospital discharge, 71 (47.0%) patients were admitted to a rehabilitation hospital, and 34 (22.5%) patients went home. The 30-day mortality rate was 13%. Patients receiving acute surgery (<12 hours) compared to subacute surgery (>12h, <2 weeks) showed no significance in functional independence scores after rehabilitation treatment. <br><br>CONCLUSION: A surge in age and bicycle-injuries in TSCI patients was observed. A substantial number of patients with TSCI were undertriaged. Acute surgery (<12 hours) showed comparable outcomes results in subacute surgery (>12h, <2 weeks) patients.<p />  <p>Language: en</p>
LA  - en
SN  - 1082-0744
UR  - http://dx.doi.org/10.46292/sci20-00002
ID  - ref1
ER  -