Comparison of Frankel Scale with Apache-II Scale in the Prediction of Early Stage Mortality of Cervical Spinal Cord Injury

Öz

Cervical spinal cord injury (CSCI) is a devastating event that can cause not only motor and sensory impairments but also autonomic dysfunction. Functional and morphological changes in the autonomic nervous system can also affect the respiratory, cardiovascular, renal and gastrointestinal systems. In our study, APACHE-II and Frankel Scale were used. The revised acute physiology and chronic health assessment system (APACHE-II) is a physiologically-based scale that includes 12 physiological parameters. The Frankel Scale was developed in 1969 by Dr. Frankel and is considered to be the pioneer of the ASIA scale for staging of Spinal Cord Injury. In this study, 47 patients who had cervical spinal cord injury between 2016 and 2020 were retrospectively analyzed. The patients were treated within 24 hours of their admission to the emergency department. Each patient's APACHE-II and Frankel scores were measured and analyzed with SPSS in terms of sensitivity, specificity, and mortality prediction. Cervical spinal cord injury is a devastating event that can cause not only motor and sensory impairments, but also autonomic dysfunction. Functional and morphological changes in the sympathetic nervous system can also affect the respiratory, cardiovascular, renal, hematological and gastrointestinal systems. These systems can be affected more than lower level spinal traumas. Therefore, patients with cervical spinal cord injury were evaluated according to both Frankel and APACHE-II classification systems in terms of mortality prediction.

Anahtar Kelimeler

• Frankel Score
• APACHE II
• Cervical Spinal Cord Injury

Kaynakça

1. REFERENCES 1-Knaus WA, Draper EA, Wagner DP, Zimmermann JE. APACHE II: a severity of disease classification system. Crit Care Med 1985; 13:818-29
2. 2-Cho Dy, Wang YC. Comparison of the APACHE III, APACHE II and Glasgow Coma Scale in acut head injury for prediction of mortality and functional outcome. İntensive Care Med 199;23:77-84
3. 3-Frankel HL, Hancock DO, Hyslop G, et al. The value of postural reduction in the initial management of closed injuries of the spine with paraplegia and tetraplegia I. Paraplegia 1969;7:179-192
4. 4-Carter RE. Respiratory aspects of spinal cord injury management. Paraplegia. 1987;25:262-266
5. 5-Lemons VR, Wagner FC Jr. Respiratory complications of cervical spinal cord injury. Spine 1994;19:2315-2320
6. 6-Kiwerski J. Respiratory problems in patients with high lesion quadriplegia. İnt. J Rehabil Res. 1992;15:49-52
7. 7-Jackson AB, Groomers TE. İncidence of respiratory complications following SCI. Arch Phys Med Rehabil.1994;75:270-275
8. 8-Claxton R, Wong D, Chung F, Fehlings M. Predictors of hospital mortality and mechanical ventilation in patients with cervical spinal cord injury. Can J Anaesth. 1998;45:144-149

9. 9-Waters R, Meyer P, Adkins R, felton D. Emergency, acute and surgical management of spine trauma. Arch Phys Med Rehabil. 1999;80:1383-1390
10. 10-Jackson AB, Groomers TE. İncidence of respiratory complications following SCI. Arch Phys Med Rehabil.1994;75:270-275
11. 11-Clinton NG. Et al Gastrointestinal Symptoms in Spinal Cord Injury: Relationships With Level of Injury and Psychologic Factors:Dis colon rectum, 48(8), 1562-1568, 2005
12. 12-Tong M., Holmes G.M. Gastric dysreflexia after acute experimental spinal cord injury in rats neurogastroenterol Motil. 2009 21,197-206
13. 13-V.P. Suttor, C. Ng, S Rutowski, R.D. Hansen, J.E. Kellow, A. Malcolm. Colorectal responses to distension and feding in patients with spinal cord injury. Am J Gastrointest Liver Physiol. 296:G1344-1349,2009
14. 14-Hagen E. M., Rekand T, Groning M., Faerestrend S. Cardiovascular complications of spinal cord injury. Tidsskr Nor Legeforen nr. 9,132:1115-20
15. 15-Chung SB, Lee SH, Kim ES, Eoh W.:Incidence of deep vein thrombosis after spinal cord injury: a prospective study in 37 consecutive patients with traumatic or nontraumatic spinal cord injury treated by mechanical prophylaxis. J Trauma. 2011 Oct;71(4):867-70
16. 16-Myers J, Lee M, Kiratli J: Cardiovascular disease in spinal cord injury: an overview of prevalence, risk, evaluation, and management. Am J Phys Med Rehabil 2007;86(2):1-11
17. 17-Furlan J. C., Krassioukov A.V., Fehlings M.G. Hematologic abnormalities within the first week after isolated traumatic cervical spinal cord injury. Spine 2006; 31(23):2674-2683
18. 18-Pettersson-Hammerstad K, Jonsson O, Svennung IB, Karlsson AK. Impaired renal function in newly spinal cord injured patients improves in the chronic state--effect of clean intermittent catheterization. J Urol. 2008 Jul;180(1):187-91
19. 19-Subramanian Vaidyanathan, Bakul Soni,Kottarathil Abraham Abraham,Peter Hughes and Gurpreet Singh.Fatal Renal Failure in a Spinal Cord Injury Patient with Vesicoureteric Reflux Who Underwent Repeated Ureteric Reimplantations Unsuccessfully: Treatment Should Focus on Abolition of High Intravesical Pressures rather than Surgical Correction of Reflux. Case Reports in Urology Volume 2012 (2012), Article ID 603715, 5 pages doi:10.1155/2012/603715)