Análise das internações hospitalares por traumas de coluna e medula decorrentes de acidentes de transporte terrestre, Minas Gerais - Brasil

Abstract

The accidentes from inland transport are one of the major and most known causes of the vertebral column injury and spinal cord trauma (SCT). Although its proportion doesnt seem significant, the relevance of its study is due to the fact that it attacks essentially male young men at productive age and it causes sequels which most of the time are irreversible. The national studies are yet incipient in the matter of epidemiological analyses of such injuries in Brazil, and mainly scarce when it comes to hospital costs of such injuries and when we consider the kind of victim and the vertebral levels that are most attacked. The present works objective was to analyse the hospitalizations in the Public Health Service (PHS) that in Portuguese is called SUS (Serviço Único de Saúde) because of column and spinal cord trauma (SCT) in the Minas Gerais State between 2009 and 2012. This present material was extracted from the database of SIH/SUS (DATASUS). The characteristics of the pacients such as age and gender, the levels of vertebral and spinal cord which are more attacked, the kind of victim in relation to the means of transportation (pedestrian, cyclist, motorcyclist, car occupant, heavy transportation occupant, bus occupant and accidents of inland transportation accident); besides the relative costs due to the hospitalizations (total and average costs for hospitalization) correspond to the analysed variants. The Cid-10 Codes of the World Health Organization were used to select the hospitalizations that corresponded to column and spinal cord trauma, as well as the selection of the involved victims. The present study has verified that there was an increasing in the number of hospitalizations due to inland accidents during all the considered period in the Minas Gerais State. The male gender was the most frequent hospitalized and the ages groups from 20 to 29 and 30 to 39 correspond to the majority of all the hospitalizations. The number of in-hospital deaths showed the same regular frequencies during all the considered years, even with the percentage of victims increasing in the period. The total and average hospital costs for treatment of the inland transportation accident had a shortage of 11,67% during the analysed period. The hospitalizations for treatment of column trauma caused by inland transportation accident exhibited the cervical spine level as the most injured part, it was also this level which was the most common attacked in men. In relation to the female gender the lumbar/sacral region was the most likely to develop either vertebral or medular traumas. When analysing the kind of victim, those who are more likely to develop trauma with or without cervical neurological deficits were: motorcyclists, occupants of motor vehicles and pedestrians. For all the victims, the relative risk was greater attacking the cervical level in relation to other parts of the column and medule. The hospital expenditures with hospitalizations either for vertebral column or spinal medulla trauma were the most costly for occupants of heavy transportation vehicles followed by inland transportation accidents. The epistemological analysis of the hospitalizations because of column trauma has cleared important aspects referring to the main causes that permeate the column and medullar fractures in Minas Gerais State. The quality of the available informations, costs and expenditures for the health public system as well as a wide-ranging and detailed of the victims' profiles may allow that more specific planning actions for health prommotion and care of the target population be more effective in preventing the column traumas.