Gastrointestinal bleeding in patients with acute spinal injuries

Area of Science:

• Trauma Surgery
• Gastroenterology
• Spinal Cord Injury Research

Background:

• Spinal cord injuries (SCIs) are severe traumatic events.
• Gastrointestinal (GI) complications are a significant concern in SCI patients.
• Understanding the incidence and causes of GI bleeds in SCI is crucial for patient management.

Purpose of the Study:

• To determine the incidence of gastrointestinal bleeds in acute male spinal cord injury patients.
• To identify the common causes and timing of GI bleeds post-injury.
• To explore potential risk factors and associations, such as injury level.

Main Methods:

• Retrospective analysis of 439 male patients admitted with acute spinal cord injuries over 11 years.
• Data collection on patient demographics, injury level (cervical, dorsal, lumbar), and occurrence of GI bleeds.
• Diagnostic workup for GI bleeds, including endoscopic findings and identified pathologies.

Main Results:

• 27 out of 439 patients (6.2%) experienced GI bleeds.
• The incidence was higher in patients with cervical spinal cord injuries.
• The most frequent diagnosis was duodenal ulcers (12 cases), followed by gastric ulcers (4 cases).
• Most bleeds occurred within 4 weeks of injury, with a mean presentation at 22.5 days.
• Malaena was the predominant clinical presentation.
• Four patients with GI bleeds died.

Conclusions:

• Gastrointestinal bleeds are a notable complication in male spinal cord injury patients, particularly those with cervical injuries.
• Peptic ulcer disease, especially duodenal ulcers, is a primary cause of GI bleeds in this population.
• Early recognition and management of GI bleeds are essential for improving outcomes in spinal cord injury patients.