Incidence of cervical spine fractures on CT: a study in a large level I trauma center

Khanpara, Shekhar; Ruiz-Pardo, Daniel; Spence, Susanna C.; West, O. Clark; Riascos, Roy

doi:10.1007/s10140-019-01717-9

Cited by 22 publications

(12 citation statements)

References 28 publications

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“…First, we had three pneumothorax cases in addition to one case of pneumomediastinum and subcutaneous emphysema among only 22 severe COVID-19 cases. There have so far been some case reports, all of which describe they are rare complications [33][34][35][36]; however, from this study it is unlikely that we can say they are rare. All cases demonstrating pneumothorax were treated by thoracostomy with trocar insertion and continuous low negative pressure.…”

Section: Treatments and Clinical Outcomesmentioning

confidence: 64%

Characteristics, laboratories, and prognosis of severe COVID-19 in the Tokyo metropolitan area: A retrospective case series

Mori

Otomo

2020

PLoS ONE

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The impact of the COVID-19 pandemic has been immense, while the epidemiology and pathophysiology remain unclear. Despite many casualties in many countries, there have been less than 1,000 deaths in Japan as of end of June, 2020. In this study, we analyzed the cases of COVID-19 patients admitted to our institution located in the Tokyo metropolitan area where the survival rate is higher than those in other cities in the world. Medical records of COVID-19 patients that were admitted to a single Japanese tertiary university hospital in the Tokyo metropolitan area between March 10th and June 2nd, 2020 were retrospectively reviewed. The identified COVID-19 cases were subdivided into two groups (severe and mild) depending on the need for mechanical ventilation. Those in the severe group required mechanical ventilation as opposed to those in the mild group. The data were analyzed using nonparametric tests expressed by median [interquartile range (IQR)]. A total of 45 COVID-19 patients were included, consisting of 22 severe cases (Group S) and 23 mild cases (Group M). Male sex (Group S, 95.5% vs. Group M, 56.5%, p<0.01), high body mass index (Group S, 24.89 [22.44-27.15] vs. Group M, 21.43 [19.05-23.75], p<0.01), and hyperlipidemia (Group S, 36.4% vs. Group M, 0%, p<0.01) were more seen in Group S. Five (22.7%) cases in Group S underwent extracorporeal membranous oxygenation (ECMO). On admission, lymphopenia, decreased albumin, and elevated fibrinogen, lactate dehydrogenase, transaminases, creatine kinase, C-reactive protein, and procalcitonin were observed in Group S. The median ICU and hospital stay were 13.5 [10.3-22.3] days and 23.0 [16.3-30.5] days, respectively, in Group S. As of June 28th, 2020, in Group S, 19 (86.4%) patients have survived, of which 17 (77.3%) were discharged, and 2 are still in treatments. Three died of multiple organ failure. All 23 patients in Group M have recovered. Male sex, high body mass index, and hyperlipidemia can be risk factors for severe COVID-19 pneumonia, and its overall short-term survival rate was between 77.3% and 86.4% in this study.

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Section: Treatments and Clinical Outcomesmentioning

confidence: 64%

Characteristics, laboratories, and prognosis of severe COVID-19 in the Tokyo metropolitan area: A retrospective case series

Mori

Otomo

2020

PLoS ONE

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“…It has been reported that the number of involved lung segments and lobes, the frequency of consolidation, the crazy paving pattern and the air bronchogram are increased in more severe cases [ 5 ]. Additionally, a correlation has been found between the PaO 2 :FiO 2 ratios, PCO 2 and SpO 2 levels and the lung involvement of the patients [ 19 , 20 ]. In one study, a weak correlation was found between the consolidation–fibrosis score and pCO 2 , while a moderate correlation was found between pO 2 and the consolidation fibrosis score in the CT scan [ 21 ].…”

Section: Discussionmentioning

confidence: 99%

Mortality Predictors in Patients Diagnosed with COVID-19 in the Emergency Department: ECG, Laboratory and CT

2021

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Background and Objectives: The aim of this study was to investigate parameters that can be used to predict mortality in patients diagnosed with COVID-19 in the emergency department (ED). Materials and Methods: Patients diagnosed with COVID-19 in the ED were included in this prospective study. The patients were divided into two groups. The surviving patients were included in Group 1 (survivors), and the patients who died were included in Group 2 (non-survivors). The electrocardiogram (ECG), laboratory results and chest computerized tomography (CCT) findings of the two groups were compared. The CCT images were classified according to the findings as normal, mild, moderate and severe. Results: Of the 419 patients included in the study, 347 (83%) survived (survivor) and 72 (17%) died (non-survivor). The heart rate and respiratory rate were found to be higher, and the peripheral oxygen saturation (SpO2) and diastolic blood pressure (DBP) were found to be lower in the non-survivor patients. QRS and corrected QT interval (QTc) were measured as longer in the non-survivor patients. In the CCT images, 79.2% of the non-survivor patients had severe findings, while 11.5% of the survivor patients had severe findings. WBC, neutrophil, NLR, lactate, D-dimer, fibrinogen, C- Reactive Protein (CRP), urea, creatinine, creatine kinase-MB (CK-MB) and hs-Troponin I levels were found to be higher and partial pressure of carbon dioxide (PCO2), base excess (BE), bicarbonate (HCO3), lymphocyte eosinophil levels were found to be lower in non-survivor patients. The highest AUC was calculated at the SpO2 level and the eosinophil level. Conclusions: COVID-19 is a fatal disease whose mortality risk can be estimated when the clinical, laboratory and imaging studies of the patients are evaluated together in the ED. SpO2 that is measured before starting oxygen therapy, the eosinophil levels and the CT findings are all important predictors of mortality risk.

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“…The ndings were consistent with other studies in which about 65 to 76 percent of the subjects were men (14)(15)(16)(17)(18)(19). In the study conducted by Khanpara et al (20), the number of men was twice that of women. Seemingly, since the prevalence of accidents is higher in men (21), injuries are more common in men than women.…”

Section: Discussionmentioning

confidence: 89%

“…Seemingly, since the prevalence of accidents is higher in men (21), injuries are more common in men than women. (20). As shown in the study of Goldberg et al (6), injuries were more common in the third decade of life.…”

Section: Discussionmentioning

confidence: 91%

Cervical X-ray versus CT scan: Radiologic Findings in Traumatic Cervical Spine Injury in Emergency Department

Seyedrezaei

Mahdavi

Noyani

et al. 2022

Preprint

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Objective: Head and neck trauma are among the most common reasons for referring to hospitals’ emergency departments. This study aimed to compare cervical X-ray and CT scans’ accuracy in diagnosing cervical spine injuries in trauma patients in Shahroud city.Materials and Methods: The present study is a cross-sectional study on patients with traumatic cervical injuries referred to the emergency department of Imam Hossein Hospital in Shahroud city from 2018 to 2019. Both cervical X-rays and CT scans were used for all patients. Firstly, the radiography, then CT scans were performed. An emergency medicine specialist and a radiologist examined crvical X-rays and CT scans separately for diagnosing cervical spine injuries. In this paper, CT scan findings were considered as the gold standard. Sensitivity, specificity, positive and negative predictive value, positive and negative likelihood were used to determine the diagnostic value of plain radiography compared to CT scan. The Kappa agreement coefficient was also calculated.Results: Out of 115 participants, 7.8% (9 patients) had cervical spine injuries period 59.1% were male, and 40.9% were female. The mean age of patients was 39.8 ± 15.3 years. Car accidents, rollover, and motorcycle accidents with 39.1, 24.3, and 20.9%, respectively, were the most common mechanisms of causing injuries in these patients. Sensitivity, specificity, positive and negative predictive value, positive and negative likelihood ratios for cervical X-ray were 55.56, 97.17, 62.5, 26.26, 96, 19.63, and 0.46%, respectively.Conclusion: According to the present study results, the accuracy of cervical X-ray compared to CT scan in diagnosing injuries occurred to the cervical spine due to trauma is low because the sensitivity of cervical X-rays in detecting injuries is very low. Therefore, it seems that the cervical X-ray cannot be considered as a suitable tool to rule out cervical spine injuries caused by trauma.

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Incidence of cervical spine fractures on CT: a study in a large level I trauma center

Cited by 22 publications

References 28 publications

Characteristics, laboratories, and prognosis of severe COVID-19 in the Tokyo metropolitan area: A retrospective case series

Characteristics, laboratories, and prognosis of severe COVID-19 in the Tokyo metropolitan area: A retrospective case series

Mortality Predictors in Patients Diagnosed with COVID-19 in the Emergency Department: ECG, Laboratory and CT

Cervical X-ray versus CT scan: Radiologic Findings in Traumatic Cervical Spine Injury in Emergency Department

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