21世纪脊髓损伤第二部分:数据缺陷
Angelica Alvarez Reyes1, Sruti Bandlamuri1, Travis M Dumont1
1Department of Neurosurgery, Banner University Medical Center, University of Arizona, Tucson, Arizona, USA.
World neurosurgery
|March 20, 2025
概括
传统的数据库无法识别没有骨折或脱位的脊髓损伤 (SCIwoFD). 需要新的SCI特定注册表来准确跟踪这个不断增长的患者群体.
科学领域:
- 创伤外科手术是什么
- 神经学 神经学
- 医疗信息学 医疗信息学
背景情况:
- 没有骨折或脱位的脊髓损伤 (SCIwoFD) 越来越常见.
- 之前的研究发现SCIwoFD是I级创伤中心中最常见的脊髓损伤.
- 传统的搜索方法可能无法有效识别SCIwoFD患者.
研究的目的:
- 评估SCIwoFD的ICD-10代码的准确性.
- 为了确定SCIwoFD患者是否可以使用机构和国家数据库来识别.
- 将SCIwoFD识别率与传统的脊髓损伤 (SCI) 数据库进行比较.
主要方法:
- 在机构层面分析了SCIwoFD患者的ICD-10代码.
- 查询了SCIwoFD和传统SCI病例的国家住院样本 (NIS) 数据库 (2015-2019).
- 在机构数据库,NIS和以前的发现之间比较患者识别率.
主要成果:
- 对SCIwoFD的机构ICD-10代码是不准确的,宫痛 (33%) 和宫脊柱狭窄 (21%) 是最常见的.
- 在NIS数据库中,SCIwoFD仅在15%的病例中被发现,而在机构队列中为82%.
- 骨折/脱位的SCI占NIS病例的85%,表明SCIwoFD在国家数据中的代表性不足.
结论:
- 机构和国家数据库 (NIS) 都无法可靠地识别患有SCIwoFD的患者.
- 准确识别SCIwoFD需要专门的,SCI特定的注册表.
- 登记册对于开发SCI这一新兴人群的最佳实践至关重要.
相关概念视频
01:54The Spinal Cord
The spinal cord is the body’s major nerve tract of the central nervous system, communicating afferent sensory information from the periphery to the brain and efferent motor information from the brain to the body. The human spinal cord extends from the hole at the base of the skull, or foramen magnum, to the level of the first or second lumbar vertebra.
01:16Spinal Cord: Cross-sectional Anatomy
The cross-sectional anatomy of the spinal cord offers a detailed view of its complex structure and function within the central nervous system. At the core of the spinal cord lies the gray matter, characterized by its butterfly or "H"-shaped appearance in cross-section. This central region is enveloped by white matter, with the overall structure divided into symmetrical halves by the dorsal median sulcus and the ventral median fissure.
Gray Matter and its Components
Central to the gray matter is...
Gray Matter and its Components
Central to the gray matter is...
01:10Spinal Cord: Information Processing
The spinal cord is an integral hub for motor and sensory information that enables the brain to communicate with the peripheral nervous system (PNS). This communication consists of relaying sensory data and transmission of motor commands.
Sensory Information Processing
Sensory information processing begins at the sensory receptors located in the skin and other tissues, which detect somatic sensory stimuli such as touch, temperature, or pain. These receptors function as catalysts, initiating...
Sensory Information Processing
Sensory information processing begins at the sensory receptors located in the skin and other tissues, which detect somatic sensory stimuli such as touch, temperature, or pain. These receptors function as catalysts, initiating...
01:26Spinal Cord
The spinal cord, a critical component of the central nervous system, extends from the base of the brainstem to the lumbar region of the vertebral column. It is essential for maintaining physical stability and facilitating communication between the brain and peripheral parts of the body.
01:14Spinal Cord Injury ll: Pathophysiology
Spinal cord injury progresses through two interconnected phases: primary injury and secondary injury.Primary InjuryPrimary injury happens at the moment of trauma and involves immediate mechanical damage to the spinal cord.Compression happens when broken vertebrae, herniated discs, or accumulating blood (such as a hematoma) press directly against the spinal cord, distorting its normal shape and function. In cases of contusion, the cord is bruised by a blunt force (like penetrating injuries or...
01:25Secondary Spinal Cord Injury llI: Pathophysiology
Early Ischemia and Ionic ImbalanceWithin minutes of spinal cord injury, a secondary cascade begins, progressing over hours to weeks. Vascular damage reduces blood flow, causing ischemia and mitochondrial dysfunction. ATP depletion leads to ion pump failure, membrane depolarization, sodium influx, potassium efflux, and water accumulation, resulting in cellular swelling. Increased intracellular calcium further disrupts mitochondria and accelerates cellular injury.Excitotoxicity and Neuronal...