The epidemiology of pre-hospital potential spinal cord injuries in Victoria, Australia: a six year retrospective cohort study

Injury Epidemiology, 2016 · DOI: 10.1186/s40621-016-0089-0 · Published: September 7, 2016

Simple Explanation

Traumatic Spinal Cord Injury (TSCI) is a devastating condition, and this study examines patients potentially at risk of TSCI in the pre-hospital setting. The study retrospectively analyzes data from Ambulance Victoria between 2007 and 2012, focusing on patients who met pre-hospital triage protocols, spinal clearance criteria, or paramedic suspicion for TSCI. Falls and traffic accidents were identified as the leading causes of injuries among these patients, highlighting the importance of prevention strategies.

Study Duration

6 Years

Participants

106,059 adult patients managed and transported by Ambulance Victoria

Evidence Level

Level 3; Retrospective cohort study

Key Findings

1
The study included 106,059 cases, representing 2.3% of all emergency transports.
2
Falls and traffic accidents were the leading causes of potential spinal cord injuries, comprising 46.9% and 39.4% of cases, respectively.
3
Males were significantly younger than females among the patients at risk of TSCI (M: 43 years vs. F: 64 years, p =0.001).

Research Summary

This study describes the epidemiology of potential TSCI in Australia using a large, state-wide sample. 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.

Practical Implications

Prevention Strategies

Implement targeted falls prevention programs, especially for the elderly, considering the circumstances and settings of falls.

Trauma Triage

Improve pre-hospital triage protocols to accurately identify patients at high risk of TSCI following traffic-related incidents, particularly among young males.

Resource Allocation

Allocate resources effectively by understanding the prevalence and causes of potential TSCI, informing policy changes and future practices in emergency medical services.

Study Limitations

1
Data may have been misreported or underreported due to the challenging pre-hospital environment where paramedics operate.
2
Missing data, particularly regarding the mechanism of injury and co-morbidities, may have led to an underestimation of PMT and potential TSCI cases.
3
Comparison to other studies was difficult due to the scarcity of EMS data, necessitating the use of trauma registries or Emergency Department registries for comparison.

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