Objective: To analyze the changes in demographic and lesion characteristics of persons with acute traumatic spinal cord injury (ATSCI) above T6 over a period of 20 years, and to evaluate their impact on ICU resources use, length of stay and mortality.

Design: Retrospective observational study.

Setting: Intensive Care Unit (ICU) of the University Hospital Complex of A Coruña, Spain.

Participants: The study included 241 persons between 1998 and 2017 with an ATSCI above T6. For the purposes of the analysis, the overall study period was divided into three subperiods.

Results: Both the mean age of the people with ATSCI (49 vs. 51 vs. 57 years; P = 0.046) and the Charlson Comorbidity Index were higher during the last subperiod (mean: 1.9 ± 2.2; P < 0.01). The most frequent cause of the injury was falls, whose percentage increased over the years. The most common classification in the American Spinal Injury Association Impairment scale was grade A. An increase in the score of the Acute Physiology and Chronic Health Evaluation (APACHE II) score was observed (median: 9 vs. 10 vs. 15; P < 0.01). The length of stay in the ICU has decreased significantly over the years (30 ± 19 vs. 22 ± 14 vs. 19 ± 13 days). No significant differences were found between the rates of ICU or in-hospital mortality recorded over the three subperiods.

Conclusions: Despite the progressive increase in the age, comorbidity, and APACHE II, the length of ICU stay decreased significantly, with no associated changes in the mortality rates.

目的：分析20年来T6以上急性创伤性脊髓损伤（ATSCI）患者的人口统计学特征和病变特征，并评估其对ICU资源使用，住院时间和死亡率的影响。

设计：回顾性观察研究。

地点：西班牙阿科鲁尼亚大学医院综合大楼的重症监护室（ICU）。

参与者：该研究包括1998年至2017年之间的241名ATSCI高于T6的人。为了分析的目的，将整个研究期分为三个子时期。

结果：在最后一个亚期间，ATSCI患者的平均年龄（49岁对51岁对57岁； P = 0.046）和查尔森合并症指数均较高（平均值：1.9±2.2； P <0.01）。造成伤害的最常见原因是跌倒，跌倒的百分比多年来呈上升趋势。在美国脊髓损伤协会减损量表中，最常见的分类是A级。观察到急性生理和慢性健康评估（APACHE II）评分的得分有所提高（中位数：9 vs. 10 vs. 15； P <0.01 ）。这些年来，ICU的住院时间显着减少（30±19 vs. 22±14 vs. 19±13天）。在三个亚期间，ICU率或院内死亡率之间均无显着差异。

结论：尽管年龄，合并症和APACHE II逐渐增加，但ICU的住院时间明显减少，死亡率没有相关变化。