Traumatismo raquimedular e fatores associados em vítimas de acidentes de trânsito

Abstract

Introduction: Traffic accidents are considered a public health problem, killing about 1.25 million people and leaving between 30 and 50 million people injured each year in the world. Among the injuries resulting from these accidents is the spinal cord trauma, with or without spinal cord injury, which can lead to premature death or social exclusion. Objective: To analyze the prevalence of spinal cord trauma (SCT) and associated factors in victims of traffic accidents hospitalized in a referral service. Material and methods: A census, descriptive and analytical cross-sectional study with a quantitative approach, performed at the Dom Luiz Gonzaga Fernandes Emergency and Trauma Hospital in the city of Campina Grande -PB. The population was constituted by 1884 medical records of victims of traffic accidents interned in the period from January to December of 2016. The following variables were analyzed: gender, age, day of the week and time of service, type of accident, use of cervical collar , presence of SCT, skeletal level of the lesion, presence of spinal cord injury, degree of disability, diagnosis of paraplegia / tetraplegia, occurrence of trauma in other regions, occurrence of craniofacial trauma, surgical procedure and outcome. Data were collected by three trained researchers, from May to December 2017, at SAME (Medical Archive and Statistics Service). The information was inserted by double typing in a database in SPSS and analyzed through descriptive and inferential statistics, with a significance level of 5% being adopted. Results: Among the victims of traffic accidents, there was predominance of males (85.4%), and the ratio between males and females was 5.8: 1. The most affected age group was 21 to 30 years (29%), with a mean age of 33.1 years. Accidents involving motorcyclists were predominant (82.9%) and 43 victims (2.3%) had Spinal cord trauma. Among the victims with SCT, the male sex was predominant (86%), the ratio between men and women being 6: 1; in the age group of 21 to 30 years (35.7%), with an average of 37.0 years. 30 cases (69.8%) presented spinal cord injury. The cervical level (55.8%) was predominant, 46.7% of the victims were classified as ASIA (American Spinal Injury Association) E. There were 9 cases (30%) of paraplegia and 1 case (3.3%) of tetraplegia. The bivariate analysis revealed a significant association between the presence of Spinal Cord Trauma and type of accident (p <0.001), use of cervical collar (p <0.005), occurrence of trauma in other anatomical regions (p <0.001), surgical treatment 0.001) and outcome of the victim's condition (p <0.005). Conclusion: Among the victims of traffic accidents and of Spinal cord trauma, there is a predominance of males, young individuals and accidents involving motorcyclists. The Spinal cord trauma was associated to the type of transport accident, use of cervical collar, trauma in other regions, surgical treatment and outcome of the victim's situation.