Risk factors predicting mortality after blunt traumatic cervical fracture
Introduction
After blunt trauma, the incidence of injuries of the cervical spine is 2–3%. Because of the importance of the neurological network located at the cervical spine, these injuries are associated with significant morbidity and mortality.19
Several methods are designed to correlate the severity of trauma and probability of survival. The most frequently used method, is the Trauma Related Injury Severity Score (TRISS). However, the use of the TRISS has yielded mixed results.4, 12 Within TRISS, the injury severity level, respiratory rate, systolic blood pressure, Glasgow coma scale, age and type of injury (blunt and penetrating) are included as factors to predict the probability of survival. However, the importance of these factors in traumatic cervical fractures is not yet clear.
Studies on risk factors for mortality after blunt cervical trauma are rather scarce. In spinal cord injury, Furlan et al.11 found that gender was not a risk factor associated with survival. They did observe a trend for higher rates of reactive depression and deep venous thrombosis in women. Bouamra et al.5 identified factors that influence significantly the mortality rate, length of stay and discharge destination in blunt trauma. They found that the effect of age on the outcome differs with regard to gender. Within this study a significant difference in survival was found between men and women.
In order to make a valid general assessment in cervical trauma of patient status and to perform triage in emergency situations, it is important to identify which factors influence mortality. The aim of the present study is therefore to identify independent risk factors associated with mortality in cervical trauma patients.
Section snippets
Patients
A consecutive series of 88 patients with blunt cervical trauma, diagnosed at the emergency department of our institution, between January 2000 and December 2005, was analysed. All patients were retrospectively identified through our electronic patient database using the International Classification of Diseases (ICD-10) and the free description line of the diagnosis.
All patient data were registered prospectively in an electronic patient database.
Procedure
Upon arrival, all patients were screened according
Results
Eighty-eight patients were included in the present study. The majority of the patients in the current study were male (n = 62; 70.5%). The mean age of the patients was 43.7 (±19.6), ranging form 15 to 96 years. Twelve patients (13.6%) died within 1-year follow-up period.
Discussion and conclusion
The present study shows that age and involvement of the third cervical vertebrae are associated with mortality in patients with trauma. Age has previously been described as a risk factor for adverse prognosis in different diseases and in cervical spine injury.9, 15 This is due to underlying degenerative changes of the spine.19, 21, 22 However, involvement of the third cervical vertebrae has not yet been described as a significant risk factor.
In the literature it is known that the Injury
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Predicting survival in older patients treated for cervical spine fractures: development of a clinical survival score
2019, Spine JournalCitation Excerpt :For example, in a cohort of elderly patients treated for cervical fractures, Harris et al. reported that age, medical comorbidities, and neurologic status were associated with 3-month and 1-year mortality [4]. Similar findings were documented in the work of Bank et al. [10], Pull ter Gunne et al. [26,27], and Young et al., who relied on data from the National Trauma Databank (NTDB) [17]. In two separate efforts, Pull ter Gunne's group identified the importance of age and neurologic injury, as modulated by the level of cervical, as prognostic of survival [26,27].
Patient demographics, insurance status, race, and ethnicity as predictors of morbidity and mortality after spine trauma: A study using the national trauma data bank
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