Risk factors predicting mortality after blunt traumatic cervical fracture

Gunne, Albert F. Pull ter; Aquarius, Annelies E.; Roukema, Jan-Anne

doi:10.1016/j.injury.2008.03.008

Cited by 13 publications

(9 citation statements)

References 21 publications

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“…[1][2][3][4][5][6][7][8] The socioeconomic realities, inadequate immediate attendant care, and the near-absent rehabilitation of people with SCI may be responsible in the developing countries. Studies 9,10 have identified many risk factors [10][11][12][13][14][15][16][17][18][19][20][21][22] for morbidity and mortality in SCI, but none of these risk factors has been studied in the developing world. Nigeria is a country without an organized prehospital transport system for trauma patients.…”

Section: Introductionmentioning

confidence: 99%

Prehospital transport of patients with spinal cord injury in Nigeria

Ahidjo

Olayinka

Olawepo

et al. 2011

The Journal of Spinal Cord Medicine

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Background: A well-organized and efficient prehospital transport is associated with improved outcome in trauma patients. In Nigeria, there is paucity of information on prehospital transport of patients with spinal cord injury (SCI) and its relation to mortality. Objective: To determine if prehospital transportation is a predictor of mortality in patients with SCI in Nigeria. Design: Prospective cohort study Methods: Prehospital transport related conditions, injury arrival intervals and persons that brought patients with SCI to the casualty were noted. Data analyzed using descriptive statistics, the chi-square test and multiple logistic regressions. Main Outcome Measures: Mortality within 6 weeks on admission Results: 168 patients with SCI presented in the casualty during this review period. Majority (67.9%) presented after 24 hrs of the injury. Majority (58.3%) were conveyed into the casualty by their relatives. Salon car (54.2%) was the most common mode of transportation where majority (55.4%) laid on their back during the transfer. Majority (75%) of the patients had multiple hospital presentation before reporting in our casualty.The mortality observed was 16.7%. Multivariate analysis after adjusting for age, gender, and means of transportation revealed that age (OR= 63.41, 95% CI= 9.24-43.53), crouched position during transfer (OR= 23.52, presentation after 24 hrs (OR=5.48,) and multiple hospital presentation (OR= 7.94, 95% CI= 1.89-33.43) were associated with mortality within 6 weeks of admission. Conclusion: A well-organized and efficient prehospital transport would reduce mortality in spinal cord injured patients. Public enlightenment campaign on factors that could reduce road traffic injury would help reduce mortality.

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Section: Introductionmentioning

confidence: 99%

Prehospital transport of patients with spinal cord injury in Nigeria

Ahidjo

Olayinka

Olawepo

et al. 2011

The Journal of Spinal Cord Medicine

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“…Age [15,16,17], gender [18], comorbidity [19], involved vertebrae (third cervical vertebrae) [20], and number of involved vertebrae [21] are known factors reported in the literature that may influence the outcome after spinal trauma. Bravo et al [22] found that the intensity of the lesion (incomplete) and vertebral displacement (<30%) are associated with neurological recovery.…”

Section: Introductionmentioning

confidence: 99%

Risk Factors for Neurological Deficiency One Year after Blunt-Induced Traumatic Cervical Fracture

2009

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Background/Aims: Little is known about the risk factors of neurological deficiency after blunt cervical fracture. This study was performed to identify factors predicting neurological deficiency after blunt cervical fracture. Methods: Within our Level I Trauma Center, we performed a retrospective case-control study. Patients with a cervical fracture after blunt trauma between January 2000 and December 2005 were identified. In total, 76 patients sustained a cervical fracture and survived 1 year after trauma. All patient files were reviewed. Patient and trauma characteristics were registered in an electronic database. Results: 26 patients were referred to the Neurology Department. Of these, 14 patients had complaints of sensory or motor loss and 12 patients were seen for sensory and motor loss. Involvement of the seventh cervical vertebrae (p = 0.030) and spinal cord compression were found to be independent significant risk factors for sensory or motor loss. The injury severity score (p = 0.001) and involvement of the vertebral body (p = 0.042) were significantly associated with sensory and motor loss. Conclusion: During patient evaluation, the identified variables should be taken into account. If one understands the risk factors, then it is possible to explain the expected outcome after the spine fracture.

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“…A recent Dutch study found that the fracture of the third cervical vertebra increased the risk of patient mortality [5]. These findings can be explained if one understands the bony anatomy, the neural anatomy, and neurologic function of different regions of the cervical spine.…”

Section: Discussionmentioning

confidence: 99%

“…Patient characteristics included age [5], sex [7], comorbidities, and mortality. Fracture characteristics were: levels of vertebrae fractured, total number of involved cervical vertebrae, type and anatomy of fracture [facet subluxation/dislocation, small bony avulsions (no teardrop fracture), odontoid, vertebral body, pedicle, lamina, spinous process, lateral mass, facet joint, or disruption of the intervertebral disk], and presence of spinal cord compression.…”

Section: Methodsmentioning

confidence: 99%

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Fracture characteristics predict patient mortality after blunt force cervical trauma

Gunne

Skolasky

Cohen

2010

European Journal of Emergency Medicine

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Fractures of the cervical spine after blunt cervical trauma are associated with high rates of patient mortality. The purpose of this study was to investigate patient and fracture characteristics that predict mortality. This is a retrospective, case cohort study of all adult patients admitted to our institution between January 1998 and June 2008 with cervical fracture after blunt cervical trauma (N=218). All patient records were reviewed. The patient and fracture characteristics and outcome data were stored. Age (P=0.002), involvement of the fourth cervical vertebra (P=0.002), lamina fracture (P=0.001), and a facet fracture (P=0.006) were identified as independent significant risk factors for mortality. In conclusion, mortality is highly affected by patient age, but fracture location and fracture pattern are also predictive of poor patient outcome. Fracture patterns may increase the risk of spinal cord injury at a level that can affect but not eliminate neural control of the diaphragm, which have the worst prognosis for patient mortality.

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Risk factors predicting mortality after blunt traumatic cervical fracture

Cited by 13 publications

References 21 publications

Prehospital transport of patients with spinal cord injury in Nigeria

Prehospital transport of patients with spinal cord injury in Nigeria

Risk Factors for Neurological Deficiency One Year after Blunt-Induced Traumatic Cervical Fracture

Fracture characteristics predict patient mortality after blunt force cervical trauma

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