MORTALITY AND ITS ASSOCIATED FACTORS IN PATIENTS WITH SPINAL CORD INJURIES AT PARAPLEGIC CENTER PESHAWAR, PAKISTAN

Abstract

OBJECTIVE: To determine mortality and its associated factors in patients with spinal cord injuries (SCI), presenting to Paraplegic Center Peshawar, Pakistan. METHODS: In this retrospective study, clinical records of SCI patients, admitted to Paraplegic Center from January 2011 to March 2017 were evaluated. SCI patients who died during this period, irrespective of their age, gender, duration of SCI and number of readmissions were included in study. Demographic information, clinical characteristic and complications in eligible patients were recorded and analyzed. RESULTS: Out of 62 patients, 46 (74.2%) were males. Mean age of patients was 41.7±17.3 years. Twenty-two (35.5%) patients aged ≤30 years & 20 (32%) patients aged >50 years. The most common cause of SCIs was fall from height (n=23, 37.1%), followed by road traffic accident (n=17, 27.4%) and firearm injury (n=11, 17.7%). About 51.6% of patients (n=32) had complete thoracic paraplegia, 30.6% (n=19) had complete cervical tetraplegia and 8.1% (n=5) had incomplete cervical tetraplegia. Complications and co-morbid conditions included pressure ulcers (n=53; 85.5%), limb fractures (n=7 11.3%), deep venous thrombosis (n=3; 4.8%), hepatitis (n=2; 3.2%) and injury to brachial plexus (n=1; 1.6%). Twenty-two (35.5%) patients underwent spine fixation surgery while forty (64.5%) patients were managed conservatively. Majority of the patients (n=51, 82.3%) died within the first year of SCI. CONCLUSION: Relatively younger patients were predominant and complete thoracic paraplegia was the commonest SCI level. Presence of pressure ulcers, limb fractures and deep venous thrombosis in patients with SCI were major contributing factors to morbidity leading to mortality in our patients.