Synchronized and integrated prehospital treatment for acute cervical spinal cord injury

Yanlin Yin; Xinming Yang; Ye Tian; Ying Zhang; Peinan Zhang; Yongli Jia; Yao Yao; Xiuyu Du; Tianmin Li; Xiaodong Li

Synchronized and integrated prehospital treatment for acute cervical spinal cord injury

Am J Transl Res. 2021 Jun 15;13(6):7008-7014. eCollection 2021.

Authors

Yanlin Yin¹, Xinming Yang¹, Ye Tian¹, Ying Zhang¹, Peinan Zhang¹, Yongli Jia¹, Yao Yao¹, Xiuyu Du², Tianmin Li³, Xiaodong Li⁴

Affiliations

¹ Department of Orthopedics, The First Affiliated Hospital of Hebei North University Zhangjiakou, Hebei Province, China.
² Department of Trauma, The First Affiliated Hospital of Hebei North University Zhangjiakou, Hebei Province, China.
³ Department of General Practice, The First Affiliated Hospital of Hebei North University Zhangjiakou, Hebei Province, China.
⁴ Department of Imaging, The First Affiliated Hospital of Hebei North University Zhangjiakou, Hebei Province, China.

PMID: 34306456
PMCID: PMC8290651

Abstract

Objective: To explore the effect of synchronized and integrated prehospital treatment strategies for on-site first aid, rescue transport and prehospital first aid in patients with acute cervical spinal cord injury.

Methods: A prospective non-randomized controlled study was designed to include patients with acute cervical spinal cord injury. A total of 50 patients were included in a Control group (before the implementation of synchronized and integrated prehospital treatment), and 50 patients were included in an Observation Group (after the implementation of synchronized and integrated prehospital treatment). We compared the timeliness of prehospital treatment, the proportion of patients received methylprednisolone treatment within 3 h after injury, the changes in Japanese Orthopaedic Association (JOA) score during transport, the incidence of adverse events, the clinical outcomes, the number of prehospital deaths, the case number of paralysis and the recovery of postoperative neural function between the two groups.

Results: Compared with the Control group, the Observation group showed significantly shorter time from injury to admission, from injury to receiving methylprednisolone pulse therapy, as well as from injury to receiving dehydrating agents and diuretics (all P<0.001). The proportion of patients received methylprednisolone treatment within 3 h after injury was significantly higher in the Observation group than that in the Control group (P<0.05). There was no significant change in the JOA score in the Observation group before and after the transport, while the score was significantly lower in the Control group after the transport (P<0.001). The JOA score was higher in the Observation group than that in the Control group at admission (P<0.001). The Observation group also showed decreased incidences of adverse events, mortality, and paralysis rate (all P<0.05) as well as better recovery of postoperative neural function (P<0.001) when compared with the Control group.

Conclusion: Synchronized and integrated prehospital treatment has a significant effect in patients with acute cervical spinal cord injury through shortening the admission time, reducing the risk of adverse events, and improving the rescue effect and the prognosis of neural function.

Keywords: Acute cervical spinal cord injury; clinical outcome; neural function; on-site treatment; prehospital first aid.