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Spinal injuries centres (SICs) for acute traumatic spinal cord injury

  1. Lisa Jones1,*,
  2. Anne-Marie Bagnall2

Editorial Group: Cochrane Injuries Group

Published Online: 18 OCT 2004

Assessed as up-to-date: 13 MAY 2003

DOI: 10.1002/14651858.CD004442.pub2


How to Cite

Jones L, Bagnall AM. Spinal injuries centres (SICs) for acute traumatic spinal cord injury. Cochrane Database of Systematic Reviews 2004, Issue 4. Art. No.: CD004442. DOI: 10.1002/14651858.CD004442.pub2.

Author Information

  1. 1

    Liverpool John Moores University, Centre for Public Health, Liverpool, UK

  2. 2

    Leeds Metropolitan University, Faculty of Health, Leeds, UK

*Lisa Jones, Centre for Public Health, Liverpool John Moores University, Castle House, North Street, Liverpool, L3 2AY, UK. L.Jones1@ljmu.ac.uk.

Publication History

  1. Publication Status: Edited (no change to conclusions)
  2. Published Online: 18 OCT 2004

SEARCH

 

Abstract

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

Background

The majority of complications in traumatic spinal cord injury (SCI) can occur in the first 24 hours and it has been suggested that spinal injury centres (SICs) may influence the pre-transfer care of people with SCI. The specialist SIC concept has been adopted in a number of high-income countries. However, even in such countries, a potentially significant number of people with SCI do not have the opportunity to access this system and are managed in a non-specialist environment.

Objectives

To answer the question: does immediate referral to an SIC result in a better outcome than delayed referral?

Search methods

The following databases were searched: AMED, CCTR, CINAHL, DARE, EMBASE, HEED, HMIC, MEDLINE, NRR, NHS EED, and PsycLIT. Searches were updated in May 2003 and included the Cochrane Injuries Group Specialist Register. The reference lists of retrieved articles were checked.

Selection criteria

Randomised controlled trials and controlled trials that compared immediate referral to an SIC with delayed referral in patients with a traumatic SCI.

Data collection and analysis

Two reviewers independently selected studies. One reviewer was to have assessed the quality of the studies and extracted data.

Main results

No randomised controlled trials or controlled trials were identified that compared immediate referral to an SIC with delayed referral in patients with a traumatic SCI. All of the studies identified were retrospective observational studies and of poor quality.

Authors' conclusions

The current evidence does not enable conclusions to be drawn about the benefits or disadvantages of immediate referral versus late referral to SICs. Well-designed, prospective experimental studies with appropriately matched controls are needed.

 

Plain language summary

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

Still not clear whether people with a spinal cord injury should go straight to a specialist centre

Spinal cord injury is a serious condition and the effects are usually permanent. In several countries, specialist centres have been set up, where patients can be taken within a few hours of their injury, but even in these countries many patients are dealt with in non-specialist hospitals. This review tried to answer the question: does immediate referral to an SIC result in a better outcome than delayed referral? However, a comprehensive search failed to find any controlled studies and so it is not yet possible to answer the question. The reviewers call for appropriate research to be done.

 

摘要

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

背景

脊柱損傷中心與急性創傷脊柱損傷

創傷脊柱損傷(SCI)的主要併發症,容易發生在最初的24小時。脊柱損傷中心(SIC)關係著SCI病人轉送前的照料。SCI專科醫師的概念在一些高所得的國家已被接受,然而在這家國家,仍有相當數目的SCI病人,沒有機會接觸這個體系,仍在非專科的環境下受到照護。

目標

問題:立即轉送病人到SIC,比延後轉送有較好的結果嗎?

搜尋策略

搜尋以下的資料庫:AMED, CCTR, CINAHL, DARE, EMBASE, HEED, HMIC, MEDLINE, NRR, NHS EED, and PsycLIT. 資料找尋到2003年5月,包括Cochrane Injuries Group Specialist Register,審閱參考文獻所提的相關文章。

選擇標準

以隨機對照試驗及對照試驗的試驗設計,比較創傷SCI的病人立即轉送到SIC與延後轉之間的差異。

資料收集與分析

兩位審核者獨立選擇研究論文,其中一位負責評估研究的品質及摘錄數據。

主要結論

隨機對照試驗及對照試驗,比較創傷性SCI被立即轉送到SIC或延後轉送的研究。所有的研究都是品質不佳的回溯性觀察報告。

作者結論

目前的証據並無法論斷立即轉送到SIC或延後,其中的優點或缺點?設計良好、預期性的實驗設計、能符合對照實驗的臨床研究是必要的。

翻譯人

本摘要由高雄榮民總醫院陳淑梅翻譯。

此翻譯計畫由臺灣國家衛生研究院(National Health Research Institutes, Taiwan)統籌。

總結

脊柱損傷的病人是否應直接送往專科醫院仍不明朗?脊柱損傷是非常嚴重的情況,通常是永久的影響。在一些國家,專科中心已設立,病人可以在幾小時內送達,但有為數不少的病人仍在非專科的醫院受到照護。這篇論述嘗試回答以下的問題:立即轉送到SIC比起延後轉送會有較好的結果?然而眾多的研究計畫中無法發現控制組的實驗設計,因此可能無法回答上述的問題。作者建議:恰當的研究計畫應該被要求執行。