Russian A.L. Polenov Neurosurgical Institute, St. Petersburg
Epidemiology and quality evaluation of medical aid at its different stages were analyzed in a series of 830 patients with combined column-spinal cord trauma in St. Petersburg, Kaliningrad, Kaluga and Syktyvkar for the one year. Frequency of combined column-spinal cord trauma among polytrauma in some regions was about 9-13%. A method of integrated quality evaluation (IQE) adapted to the given problem was used. The majority of the patients with combined injury were primarily cured by emergency service, the staff of which experienced considerable difficulties in diagnose-making (45-55%). The causes of hospital-stage diagnostic defects were insufficient and delayed patient’s examination (12-15%). Surgical treatment IQE made 0.87. The main defects were improper timing and surgical volume chosen (39.0%), undue technique of performing surgery (10.2%). Hospital lethality in these injuries was 21.6%.
combined column-spinal cord trauma, epidemiology, quality of medical aid.