Epidemiology and predictors of traumatic spine injury in severely injured patients: implications for emergency procedure
- PDF / 765,524 Bytes
- 9 Pages / 595.276 x 790.866 pts Page_size
- 25 Downloads / 179 Views
ORIGINAL ARTICLE
Epidemiology and predictors of traumatic spine injury in severely injured patients: implications for emergency procedures David Häske1,2 · Rolf Lefering3 · Jan‑Philipp Stock4 · Michael Kreinest5 · The TraumaRegister DGU6 Received: 29 July 2020 / Accepted: 25 September 2020 © The Author(s) 2020
Abstract Purpose This study aimed to identify the prevalence and predictors of spinal injuries that are suitable for immobilization. Methods Retrospective cohort study drawing from the multi-center database of the TraumaRegister DGU®, spinal injury patients ≥ 16 years of age who scored ≥ 3 on the Abbreviated Injury Scale (AIS) between 2009 and 2016 were enrolled. Results The mean age of the 145,833 patients enrolled was 52.7 ± 21.1 years. The hospital mortality rate was 13.9%, and the mean injury severity score (ISS) was 21.8 ± 11.8. Seventy percent of patients had no spine injury, 25.9% scored 2–3 on the AIS, and 4.1% scored 4–6 on the AIS. Among patients with isolated traumatic brain injury (TBI), 26.8% had spinal injuries with an AIS score of 4–6. Among patients with multi-system trauma and TBI, 44.7% had spinal injuries that scored 4–6 on the AIS. Regression analysis predicted a serious spine injury (SI; AIS 3–6) with a prevalence of 10.6% and cervical spine injury (CSI; AIS 3–6) with a prevalence of 5.1%. Blunt trauma was a predictor for SI and CSI (OR 4.066 and OR 3.640, respectively; both p 3 m for SI (OR 2.243; p 2 m, as well as in patients > 65 years-old [16]. A registry study on spinal cord injuries showed that traumatic brain injuries (TBIs), shock at the scene, the severity of injuries, and age > 60 years, worsen the outcome [17]. While anatomy has not changed over the decades, leisure behaviors and
13
D. Häske et al.
safety techniques have (e.g., wearing seatbelts in vehicles) [18, 19], and with it the question of the generalizability of non-European studies [12, 13, 20].
Goals of this investigation As such, this study aims to identify the epidemiological characteristics and possible predictors of spinal injury in severely injured patients in Europe.
Materials and methods Study design Data from the TraumaRegister D GU® (TR-DGU) were retrospectively analyzed.
Database The TR-DGU of the German Trauma Society [Deutsche Gesellschaft für Unfallchirurgie (DGU)] was founded in 1993. The aim of this multi-center database is to collect pseudonymized and standardized documentation of severely injured patients. Data are collected prospectively in four consecutive phases from the site of the accident until discharge from hospital: pre-hospital phase, emergency room and initial surgery phase, intensive care phase, and discharge phase. The documentation includes detailed information on demographics, injury pattern, comorbidities, pre- and inhospital management, the course in the intensive care unit (ICU), relevant laboratory findings (including data on transfusion), and the outcomes of each patient. The inclusion criteria comprised (1) hospital admission via an emergency room with subsequen
Data Loading...
