Surgically managed traumatic spinal cord injury in Singapore: a descriptive study across two level one trauma centres

Study design

Case Series

Objectives

To provide an updated understanding of the incidence of surgically managed Traumatic Spinal Cord Injury (TSCI) in Singapore and to identify factors affecting discharge disposition.

Setting

Patients were identified from two level one trauma centres in Singapore.

Methods

All patients who underwent surgical management for acute TSCI between January 2020 to December 2021 were included. Demographics, injury details, peri-operative condition, hospital length of stay (LOS) and discharge disposition were evaluated. The overall characteristics of TSCI were summarised using descriptive statistics. The difference between discharge destinations was compared using chi-square test or t test. Variables with p values < 0.3 were selected for multivariable analysis.

Results

Forty-four patients were included. Median age was 65. The most common SCI aetiology was fall from standing height or less (54.6%). Accidents involving personal mobility devices, bicycles and motor vehicles made up the next largest group (20.5%). Thirty-nine cases (88.6%) involved the cervical region. There were two cases of inpatient mortality. Twenty-one patients (50%) were discharged home, 21 (50%) were discharged to a community hospital (CH) or nursing home (NH). The median LOS in an acute hospital was 41 days. Multivariable logistic regression analysis revealed that functional independence measure (FIM) score on discharge was an independent factor that influenced discharge disposition (p = 0.037).

Conclusion

A public health focus on falls prevention, the development of geriatric spinal rehabilitation programs, and the consideration of a national registry are recommended for the comprehensive management of TSCI in Singapore.