Citation

Tee JW, Chan PC, Gruen RL, Fitzgerald MC, Liew SM, Cameron PA, Rosenfeld JV. Spine 2013; 38(2): 169-177.

Affiliation

1Department of Neurosurgery, The Alfred, Melbourne 2Trauma Service, The Alfred, Melbourne 3Department of Orthopaedics, The Alfred, Melbourne 4Department of Emergency Medicine, The Alfred, Melbourne 5Department of Surgery, Monash University, Melbourne 6National Trauma Research Institute, Melbourne 7Monash Institute for Brain Development and Repair 8School of Public Health and Preventive Medicine, Monash University.

Copyright

(Copyright © 2013, Lippincott Williams and Wilkins)

DOI

10.1097/BRS.0b013e3182634cbf

PMID

22691920

Abstract

Study Design. Retrospective cohort study.Objective. To identify early independent mortality predictors following spine trauma.Summary of Background Data. Spine trauma consists of spinal cord and spine column injury. The ability to identify early (within 24 hours) risk factors predictive of mortality in spine trauma has the potential to reduce mortality and improve spine trauma management.Methods. Analysis was performed on 215 spine column and/or spinal cord injured patients from July 2008 to August 2011. Univariate and multivariate logistic regression models were applied to investigate the effects of the Injury Severity Score (ISS), age, mechanism of injury, blood sugar level, vital signs, brain trauma severity, morbidity prior to trauma, coagulation profile, neurological status, and spine injuries on the risk of in-hospital death.Results. Applying a multivariate logistic regression model, there were seven independent early predictive factors for mortality after spine injury. They were (1) ISS > 15 (OR = 3.67, P = 0.009), (2) abnormal coagulation profile (OR = 6; P = <0.0001), (3) patients ≥ 65 years (OR = 3.49; P = 0.007), (4) hypotension (OR = 2.9; P = 0.033), (5) tachycardia (OR = 4.04; P = 0.005), (6) hypoxia (OR = 2.9; P = 0.033) and (7) multiple comorbidities (OR = 3.49; P = 0.007). Severe TBI was also associated with mortality but was excluded from multivariate analysis, as there were no patients with this variable in the comparison group.Conclusion. Mortality predictors for spine trauma patients are similar to those for general trauma patients. Spine injury variables were shown not to be independent predictors of spine trauma mortality.

Language: en