Early stages management of traumatic spinal cord injury in Latin America: a scoping review

Study design: scoping review OBJECTIVES: to understand the extent and type of evidence on diagnosis, clinical presentation, management, outcomes, and costs of traumatic spinal cord injury (TSCI) in the early stages in Latin America. Methods: the Joanna Briggs Institute (JBI) methodology for scoping reviews was followed. Extracted data included study aim, country, methodology, population characteristics, and outcome measures. Results: thirteen studies met the inclusion criteria. Studies were grouped into five categories: associated lesions and intensive care unit (ICU); treatment; complications; neurological outcomes; length of hospital stay (LOS), costs, and mortality. Studies were from Brazil, Mexico, Argentina, Colombia, Chile, and one included several countries. A significant number of patients had associated injuries, little information was found about ICU management. A high variability existed in the surgical and conservative management rate. Some medical therapies were found to be used that could partially alleviate the neurological symptoms. Most complications were preventable, not always directly related to the event, and could be associated with increased mortality. LOS could be related to complications and to the type of interventions required that, in turn, could increase the in-hospital costs. Conclusions: the information about the management of TSCI in the early stages in Latin America is far from being exhaustive and a high variability exists among the studies in all the examined sections. Nevertheless, many patients are polytraumatized, and little is known about ICU requirement. Treatment is heterogeneous and the complications are in many cases preventable conditions that can increase LOS, costs, and mortality.