World Journal of Trauma and Critical Care Medicine Volume No 5

Original Article Open Access

Epidemiology of Cervical Spine Lesions in the Multiply Injured Patient – Recent Data of the Traumaregister DGU®

Matthias Weuster, Tim Klueter, Christina Hofgaertner, Peter Beherndt, Leif Menzdrof, Rolf Lefering, Stefanie Fitschen-Oestern, Andreas Seekamp, Sebastian Lippross and Trauma Register DGU
World Journal of Trauma and Critical Care Medicine 2016, 4:3

Abstract

Introduction

A cervical spine lesion (CSL) is common among polytrauma patients. Injuries may be life threatening. The clinical impact of CSL in multiple injured patients is the focus of this study.

Methods

A retrospective investigation on a total of 62,903 patients of the Trauma Register DGU® from 2009 and 2014 was performed. Preclinical and clinical data were analyzed.

Results

The cohort depicted the typical severity in polytrauma (mean age 51 ±21; mean ISS of 22 ± 12). 1,321 patients sustained a CSL with an AIS 4-6 including complete spinal cord syndrome. The number of male patients was more than twice as high as of female patients. Leading causes for CSL were car accidents, falls from <3m height and falls from >3m height. 12,023 patients were unconscious (GCS ≤8). The majority had a CSL of AIS <2. 406 unconscious patients suffered from a CSL with an AIS 4-6. Cardiopulmonary resuscitation (CPR) was performed in 2,000 patients in the preclinical setting and 1,003 patients received CPR in the resuscitation bay. Severe CSL (AIS 4-6) had a significantly lower blood pressure (102mmHg ± 46) and a significantly lower heart rate (74/min ± 34) than patients with less severe CSLs (AIS <2). Hospitalization was extended with the severity of CSL. Early mortality was high. More than half of the patients with CSLs (AIS 2-6) died within the first 24 hours. 404 patients were transferred to a rehabilitation facility.

Conclusion

Cervical spine lesions imply a peculiar element among polytrauma patients. Early mortality correlates with the severity of CSL. Rehabilitation facilities are mainly the end point.

Keywords

Cervical spine lesion, spinal cord injury, Glasgow Coma Scale, multiple trauma, TraumaRegister DGU® (TR-DGU)




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