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Nontraumatic spinal cord injury at the neurological intensive care unit: spectrum, causes of admission and predictors of mortality.
Grassner, L; Marschallinger, J; Dünser, MW; Novak, HF; Zerbs, A; Aigner, L; Trinka, E; Sellner, J;
Ther Adv Neurol Disord. 2016; 9(2):85-94
Originalarbeiten (Zeitschrift)

PMU-Autor/inn/en

Aigner Ludwig
Dünser Martin
Grassner Lukas
Marschallinger Julia
Novak Helmut
Sellner Johann
Trinka Eugen
Zerbs Alexander

Abstract

OBJECTIVE
Nontraumatic spinal cord injuries (NTSCIs) form a heterogeneous group of diseases, which may evolve into a life-threatening condition. We sought to characterize spectrum, causes of admission and predictors of death in patients with NTSCI treated at the neurological intensive care unit (NICU).
We performed a retrospective observational analysis of NTSCI cases treated at a tertiary care center between 2001 and 2013. Among the 3937 NICU admissions were 93 patients with NTSCI (2.4%). Using multivariate logistic regression analysis, we examined predictors of mortality including demographics, etiology, reasons for admission and GCS/SAPS (Glasgow Coma Scale/Simplified Acute Physiology Score) scores.
Infectious and inflammatory/autoimmune causes made up 50% of the NTSCI cases. The most common reasons for NICU admission were rapidly progressing paresis (49.5%) and abundance of respiratory insufficiency (26.9%). The mortality rate was 22.6% and 2.5-fold higher than in the cohort of all other patients treated at the NICU. Respiratory insufficiency as the reason for NICU admission [odds ratio (OR) 4.97, 95% confidence interval (CI) 1.38-17.9; p < 0.01], high initial SAPS scores (OR 1.04; 95% CI 1.003-1.08; p = 0.04), and the development of acute kidney injury throughout the stay (OR 7.25, 1.9-27.5; p = 0.004) were independent risk factors for NICU death.
Patients with NTSCI account for a subset of patients admitted to the NICU and are at risk for adverse outcome. A better understanding of predisposing conditions and further knowledge of management of critically ill patients with NTSCI is mandatory.


Find related publications in this database (Keywords)

intensive care
mortality
nontraumatic spinal cord injury
treatment