Univariate and Multivariable Analyses on Independent Predictors for Cervical Spinal Injury in Patients with Head Injury.

Autor: Chan DYC; Division of Neurosurgery, Department of Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, New Territories, Hong Kong SAR. Electronic address: davidchan@surgery.cuhk.edu.hk., He OY; Division of Neurosurgery, Department of Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, New Territories, Hong Kong SAR., Poon WS; Division of Neurosurgery, Department of Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, New Territories, Hong Kong SAR., Ng SCP; Division of Neurosurgery, Department of Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, New Territories, Hong Kong SAR., Yeung JHH; Trauma Service, Princess Margaret Hospital, Kowloon, Hong Kong SAR., Hung KKC; Accident and Emergency Medicine Academic Unit, Faculty of Medicine, The Chinese University of Hong Kong, New Territories, Hong Kong SAR, Hong Kong; School of Public Health and Primary Care, The Chinese University of Hong Kong, New Territories, Hong Kong SAR; Trauma and Emergency Centre, Prince of Wales Hospital, New Territories, Hong Kong SAR., Mak WK; Division of Neurosurgery, Department of Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, New Territories, Hong Kong SAR., Chan DTM; Division of Neurosurgery, Department of Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, New Territories, Hong Kong SAR., Cheung NK; Accident and Emergency Medicine Academic Unit, Faculty of Medicine, The Chinese University of Hong Kong, New Territories, Hong Kong SAR, Hong Kong; Trauma and Emergency Centre, Prince of Wales Hospital, New Territories, Hong Kong SAR., Griffith JF; Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, New Territories, Hong Kong SAR., Graham CA; Accident and Emergency Medicine Academic Unit, Faculty of Medicine, The Chinese University of Hong Kong, New Territories, Hong Kong SAR, Hong Kong; School of Public Health and Primary Care, The Chinese University of Hong Kong, New Territories, Hong Kong SAR; Trauma and Emergency Centre, Prince of Wales Hospital, New Territories, Hong Kong SAR., Wong GKC; Division of Neurosurgery, Department of Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, New Territories, Hong Kong SAR.
Jazyk: angličtina
Zdroj: World neurosurgery [World Neurosurg] 2022 Oct; Vol. 166, pp. e832-e840. Date of Electronic Publication: 2022 Aug 01.
DOI: 10.1016/j.wneu.2022.07.105
Abstrakt: Objective: This study aims to identify independent factors associated with cervical spinal injuries in head-injured patients. The extent of injuries to other body parts was assessed by the Abbreviated Injury Scale (AIS) and was included in the analysis.
Methods: Consecutive head-injured patients admitted via the emergency department from January 1, 2014 to December 31, 2016 were retrospectively reviewed. The inclusion criteria were head-injured patients with an Abbreviated Injury Scale (AIS) score ≥2 (i.e., head injuries with intracranial hematoma or skull fracture). Patients with minor head injuries with only scalp abrasions or superficial lacerations without significant intracranial injuries (i.e., head injury AIS score = 1) were excluded. The primary outcome was to identify independent predictors associated with cervical spinal injuries in these head-injured patients. Univariate and multivariable analyses were conducted.
Results: A total of 1105 patients were identified. Of these patients, 11.2% (n = 124) had cervical spinal injuries. Univariate and multivariable analyses identified male gender (P = 0.006), the presence of thoracic injury (including rib fracture, hemothorax, or pneumothorax) (P = 0.010), and hypotension with systolic blood pressure <90 mm Hg on admission (P = 0.009) as independent predictors for cervical spinal injury in head-injured patients.
Conclusions: This study showed that about 1 in 10 patients with significant head injury had cervical spine injury, usually associated with fracture or dislocation. Male gender, the presence of thoracic injury, and hypotension on admission were independent risk factors associated with cervical spinal injuries.
(Copyright © 2022 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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