G H Ungar

A prospective system of data collection, using computer storage, has been developed in the Spinal Injuries Unit, Austin Hospital. Three hundred and fifty-two consecutive admissions to the Unit between 1 July 1978 and 31 December 1982 are analysed, and this epidemiological data compared with other reports. Over 92% of the admissions were the result of spinal cord trauma and the balance due to a variety of non-traumatic causes. A high incidence of young males injured in road accidents, predominantly from motor cars, and lesser numbers from sporting, occupational and domestic accidents is noted. A high proportion of country accidents and a disproportionately high number of people who live in country areas indicates the need for greater concentration of preventative measures to rural areas. The study has confirmed the usefulness of such a sophisticated data collection system to collect, at relatively low cost, useful epidemiological data on a specific disability group. The system will help to plan treatment programmes, as well as preventative measures, for the future.

The data collection system described in a previous study has been used to analyze some of the results of treatment of 352 consecutive admissions to the Spinal Injuries Unit, Austin Hospital. The results indicate that the basically conservative approach to the management of the spinal injury, supplemented by surgery in selected cases, appears to be vindicated by the low rate of instability of the spine, and good neurological sequelae of the spinal cord injury. An intermittent catheter regimen for management of the neurogenic bladder has resulted in a low rate of permanent indwelling catheterization on discharge from hospital and a low rate of urinary infections. The survival rate of patients in a well integrated unit, with a multi-disciplinary team, is high. The relatively long periods of hospitalization are justified by the return to the community of a high proportion of independent, healthy, disabled people.