Traumatic Spinal Cord Injury: Retrospective Evaluation of Epidemiological and Hematological Profiles

Abstract

Background: Traumatic spinal cord injury (TSCI) represents a major public health concern, with significant long-term consequences for patients’ physical, psychological, and social functioning. Understanding epidemiological patterns and identifying reliable hematological markers associated with functional outcomes may help in optimizing clinical management.

Methods: Medical records of patients with TSCI admitted to Xuanwu Hospital, Capital Medical University, between January 2015 and December 2021 were retrospectively reviewed. A total of 129 cases were included for epidemiological analysis. For hematological profiling, 106 patients with cervical TSCI who were admitted within six months of injury and had complete laboratory data were analyzed. Epidemiological variables included demographic details, etiology, injury level, treatment, time to hospital, and discharge destination. Hematological variables assessed at admission included white blood cell count, neutrophil and lymphocyte counts and percentages, hemoglobin (Hb), platelets (PLT), albumin (Alb), glucose, and fibrinogen. Functional outcome was assessed using the Barthel Index (BI) at admission and discharge. Statistical analyses included independent-samples t-tests, Mann–Whitney U-tests, binary logistic regression, and ROC curve analysis.

Results: The mean age of patients was 56.3 ± 13.3 years, with the 46–60-year group being the most affected (49.6%). The male-to-female ratio was 2.5:1. Low fall (50.4%) was the leading cause of injury, followed by transport-related accidents (25.6%) and falls from height (13.2%). The majority of injuries involved the cervical spine (86.0%), with C5 being the most frequent level. Surgical treatment was performed in 91.5% of cases. At discharge, only 27.2% of patients had received rehabilitation therapy. Hematological analysis revealed that patients with increased BI scores had significantly higher admission levels of Hb (137.7 ± 16.8 g/L vs. 125.9 ± 19.6 g/L, p=0.008) and Alb (37.3 ± 4.7 g/L vs. 34.1 ± 5.3 g/L, p=0.001). Logistic regression identified Alb as an independent predictor of functional improvement (OR=1.121, p=0.039). ROC analysis determined a cut-off Alb level of 33.16 g/L (AUC=0.669).

Conclusions: TSCI in Turkey predominantly affects middle-aged men, with low falls being the major etiology and cervical spine injuries the most common. Admission albumin level was independently associated with functional improvement during hospitalization, suggesting its potential as a readily available prognostic marker. Larger, prospective, and multicentre studies are warranted to validate these findings.