急性外傷性脊髓損傷病人使用甲基去氫氧化可體松的併發症

Translated title of the contribution: Adverse Effect of Treatment with Methylprednisolone in Acute Traumatic Spinal Cord Injury: A Pilot Study

Carlos Lam, Wen-Ta Chiu, Ming Fu Chiang, Cheng Yao Liu, Shin-Han Tsai, Mau-Roung Lin

Research output: Contribution to journalArticle

Abstract

OBJECTIVES: This study is intended to investigate the adverse effects with and without methylprednisolone treatment among 110 patients who had acute traumatic spinal cord injury and were treated in medical centers and regional hospitals during the period from June 1, 2000 to May 31, 2001.
METHOD: The data of 110 patients aged 16 through 90 years were collected and evaluated for in-hospital mortality and complications. The patients with isolated nerve-root disorder or open neck wound were excluded from the study. The patients were divided into two groups: those treated with methylprednisolone and those treated without methylprednisolone after hospital admission.
Comparisons of these two groups included 13 demographic and clinical characteristics: age; cause of injury; the number of associated injuries; time between injury and admission; severity of the spinal cord injury; level of the spinal cord injury; completeness of the spinal cord injury; mean blood pressure on admission; Revised Trauma Score on admission; Glasgow Coma Scale; number and type of spinal surgery; rehabilitation after admission.
RESULTS: Comparison between the group treated with methylprednisolone and the group treated without methylprednisolone shows the following results (methylprednisolone/without methylprednisolone):
Frequency of in-hospital complications: 1.29/0.87 (P=0.099). Number of patients who died in-hospital: 2/1 (P=0.714). Number of complications: Upper gastrointestinal bleeding: 6/1 (P=0.418). Neurogenic bladder: 25/10 (P=0.303). Respiratory failure: 9/4 (P=0.483). Pressure ulcer: 9/3 (P=0.534). Sepsis: 2/0 (P=0.538). Pneumonia: 12/4 (P=0.344). Urinary tract infection: 20/5 (P=0.066). Infectious complication: 42/17 (P0.038).
CONCLUSIONS: The results of this study suggest that patients with spinal cord injury are more likely to have infectious complications if treated with methylprednisolone. However, there are no significant differences among mortality or other complications whether the patients receive or do not receive methylprednisolone treatment. This study also shows that the severity and completeness of spinal cord injury influence the development of infection significantly after use of methyiprednisolone.
Translated title of the contributionAdverse Effect of Treatment with Methylprednisolone in Acute Traumatic Spinal Cord Injury: A Pilot Study
Original languageTraditional Chinese
Pages (from-to)146-154
Number of pages9
Journal中華民國急救加護醫學會雜誌
Volume14
Issue number4
Publication statusPublished - 2003

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