The epidemiology of pre-hospital potential spinal cord injuries in Victoria, Australia

A six year retrospective cohort study

Research output: Contribution to journalArticleResearchpeer-review

Abstract

Background
Traumatic Spinal Cord Injury (TSCI) is relatively uncommon, yet a devastating and costly condition. Despite the human and social impacts, studies describing patients with potential TSCI in the pre-hospital setting are scarce. This paper aims to describe the epidemiology of patients potentially at risk of or suspected to have a TSCI by paramedics, with a view to providing a better understanding of factors associated with potential TSCI.
Methods
This is a retrospective cohort study of all adult patients managed and transported by Ambulance Victoria (AV) between 01 January 2007 and 31 December 2012 who, based on meeting pre-hospital triage protocols and criteria for spinal clearance, paramedic suspicion or spinal immobilisation, were classified to be at risk of or suspected to have a TSCI. Data was extracted from the AV data warehouse, including demographic details, trauma aetiology, paramedic assessment, management and other event characteristics.
Results
A total of 106,059cases were included in the study, representing 2.3 % of all emergency transports by AV. Subjects had a median age of 51 years (interquartile range; 29–78) and 52.4 % were males (95 % CI 52–52.7). Males were significantly younger than females (M: 43 years [26–65] vs. F: 64 years [36–84], p =0.001). Falls and traffic accidents were the leading causes of injuries, comprising 46.9 and 39.4 % of cases, respectively. Other causes included accidents due to sport, animals, industrial work and diving, as well as violence and hanging. 29.9 % of patients were transported to a Major Trauma Service (MTS). A proportion of 48.8 % of the study population met the Pre-hospital Major Trauma criteria.
Conclusion
This is the first study to describe the epidemiology of potential TSCI in Australia and is based on a large, state-wide sample. It provides background knowledge and a baseline for future research, as well as a reference point for future in policy. Falling and traffic related injuries were the leading causes of potential SCI. Future research is required to identify the proportion of confirmed TSCI among the potentials and factors associated with TSCI in prehospital settings.
Original languageEnglish
Article number25
Number of pages8
JournalInjury Epidemiology
Volume3
DOIs
Publication statusPublished - 17 Oct 2016

Keywords

  • Pre-hospital
  • Emergency Medical Services
  • Potential SCI
  • Suspected SCI
  • Traumatic SCI
  • TSCI
  • Epidemiology
  • Trauma

Cite this

@article{a668da1997e34712905b7e1105486770,
title = "The epidemiology of pre-hospital potential spinal cord injuries in Victoria, Australia: A six year retrospective cohort study",
abstract = "BackgroundTraumatic Spinal Cord Injury (TSCI) is relatively uncommon, yet a devastating and costly condition. Despite the human and social impacts, studies describing patients with potential TSCI in the pre-hospital setting are scarce. This paper aims to describe the epidemiology of patients potentially at risk of or suspected to have a TSCI by paramedics, with a view to providing a better understanding of factors associated with potential TSCI.MethodsThis is a retrospective cohort study of all adult patients managed and transported by Ambulance Victoria (AV) between 01 January 2007 and 31 December 2012 who, based on meeting pre-hospital triage protocols and criteria for spinal clearance, paramedic suspicion or spinal immobilisation, were classified to be at risk of or suspected to have a TSCI. Data was extracted from the AV data warehouse, including demographic details, trauma aetiology, paramedic assessment, management and other event characteristics.ResultsA total of 106,059cases were included in the study, representing 2.3 {\%} of all emergency transports by AV. Subjects had a median age of 51 years (interquartile range; 29–78) and 52.4 {\%} were males (95 {\%} CI 52–52.7). Males were significantly younger than females (M: 43 years [26–65] vs. F: 64 years [36–84], p =0.001). Falls and traffic accidents were the leading causes of injuries, comprising 46.9 and 39.4 {\%} of cases, respectively. Other causes included accidents due to sport, animals, industrial work and diving, as well as violence and hanging. 29.9 {\%} of patients were transported to a Major Trauma Service (MTS). A proportion of 48.8 {\%} of the study population met the Pre-hospital Major Trauma criteria.ConclusionThis is the first study to describe the epidemiology of potential TSCI in Australia and is based on a large, state-wide sample. It provides background knowledge and a baseline for future research, as well as a reference point for future in policy. Falling and traffic related injuries were the leading causes of potential SCI. Future research is required to identify the proportion of confirmed TSCI among the potentials and factors associated with TSCI in prehospital settings.",
keywords = "Pre-hospital, Emergency Medical Services, Potential SCI, Suspected SCI, Traumatic SCI, TSCI, Epidemiology, Trauma",
author = "Oteir, {Ala'a O.} and Karen Smith and Stoelwinder, {Johannes U.} and Shelley Cox and James Middleton and Jennings, {Paul A.}",
year = "2016",
month = "10",
day = "17",
doi = "10.1186/s40621-016-0089-0",
language = "English",
volume = "3",
journal = "Injury Epidemiology",
issn = "2197-1714",
publisher = "Springer-Verlag London Ltd.",

}

TY - JOUR

T1 - The epidemiology of pre-hospital potential spinal cord injuries in Victoria, Australia

T2 - A six year retrospective cohort study

AU - Oteir, Ala'a O.

AU - Smith, Karen

AU - Stoelwinder, Johannes U.

AU - Cox, Shelley

AU - Middleton, James

AU - Jennings, Paul A.

PY - 2016/10/17

Y1 - 2016/10/17

N2 - BackgroundTraumatic Spinal Cord Injury (TSCI) is relatively uncommon, yet a devastating and costly condition. Despite the human and social impacts, studies describing patients with potential TSCI in the pre-hospital setting are scarce. This paper aims to describe the epidemiology of patients potentially at risk of or suspected to have a TSCI by paramedics, with a view to providing a better understanding of factors associated with potential TSCI.MethodsThis is a retrospective cohort study of all adult patients managed and transported by Ambulance Victoria (AV) between 01 January 2007 and 31 December 2012 who, based on meeting pre-hospital triage protocols and criteria for spinal clearance, paramedic suspicion or spinal immobilisation, were classified to be at risk of or suspected to have a TSCI. Data was extracted from the AV data warehouse, including demographic details, trauma aetiology, paramedic assessment, management and other event characteristics.ResultsA total of 106,059cases were included in the study, representing 2.3 % of all emergency transports by AV. Subjects had a median age of 51 years (interquartile range; 29–78) and 52.4 % were males (95 % CI 52–52.7). Males were significantly younger than females (M: 43 years [26–65] vs. F: 64 years [36–84], p =0.001). Falls and traffic accidents were the leading causes of injuries, comprising 46.9 and 39.4 % of cases, respectively. Other causes included accidents due to sport, animals, industrial work and diving, as well as violence and hanging. 29.9 % of patients were transported to a Major Trauma Service (MTS). A proportion of 48.8 % of the study population met the Pre-hospital Major Trauma criteria.ConclusionThis is the first study to describe the epidemiology of potential TSCI in Australia and is based on a large, state-wide sample. It provides background knowledge and a baseline for future research, as well as a reference point for future in policy. Falling and traffic related injuries were the leading causes of potential SCI. Future research is required to identify the proportion of confirmed TSCI among the potentials and factors associated with TSCI in prehospital settings.

AB - BackgroundTraumatic Spinal Cord Injury (TSCI) is relatively uncommon, yet a devastating and costly condition. Despite the human and social impacts, studies describing patients with potential TSCI in the pre-hospital setting are scarce. This paper aims to describe the epidemiology of patients potentially at risk of or suspected to have a TSCI by paramedics, with a view to providing a better understanding of factors associated with potential TSCI.MethodsThis is a retrospective cohort study of all adult patients managed and transported by Ambulance Victoria (AV) between 01 January 2007 and 31 December 2012 who, based on meeting pre-hospital triage protocols and criteria for spinal clearance, paramedic suspicion or spinal immobilisation, were classified to be at risk of or suspected to have a TSCI. Data was extracted from the AV data warehouse, including demographic details, trauma aetiology, paramedic assessment, management and other event characteristics.ResultsA total of 106,059cases were included in the study, representing 2.3 % of all emergency transports by AV. Subjects had a median age of 51 years (interquartile range; 29–78) and 52.4 % were males (95 % CI 52–52.7). Males were significantly younger than females (M: 43 years [26–65] vs. F: 64 years [36–84], p =0.001). Falls and traffic accidents were the leading causes of injuries, comprising 46.9 and 39.4 % of cases, respectively. Other causes included accidents due to sport, animals, industrial work and diving, as well as violence and hanging. 29.9 % of patients were transported to a Major Trauma Service (MTS). A proportion of 48.8 % of the study population met the Pre-hospital Major Trauma criteria.ConclusionThis is the first study to describe the epidemiology of potential TSCI in Australia and is based on a large, state-wide sample. It provides background knowledge and a baseline for future research, as well as a reference point for future in policy. Falling and traffic related injuries were the leading causes of potential SCI. Future research is required to identify the proportion of confirmed TSCI among the potentials and factors associated with TSCI in prehospital settings.

KW - Pre-hospital

KW - Emergency Medical Services

KW - Potential SCI

KW - Suspected SCI

KW - Traumatic SCI

KW - TSCI

KW - Epidemiology

KW - Trauma

UR - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5065940/pdf/40621_2016_Article_89.pdf

U2 - 10.1186/s40621-016-0089-0

DO - 10.1186/s40621-016-0089-0

M3 - Article

VL - 3

JO - Injury Epidemiology

JF - Injury Epidemiology

SN - 2197-1714

M1 - 25

ER -