Risk factors for cervical spine injury among patients with traumatic brain injury Open Access

Fujii, Tomoko (2011)

Permanent URL: https://etd.library.emory.edu/concern/etds/kh04dq08s?locale=en
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Abstract


Abstract


Study Objective: Diagnosis of cervical spine injury is difficult for patients with altered
level of consciousness due to traumatic brain injury (TBI). Some studies reported
increased risk of cervical spine injury among patients with TBI and older adults are at
higher risk for TBI caused by fall injuries. This study examined factors associated with
cervical spine injury among TBI patients and investigated whether older adults are
disproportionally at higher risk for cervical spine injury when they sustain TBI from a
fall-related injury.


Methods: All trauma cases with TBI in the National Trauma Data Bank (NTDB)
National Sample Project (NSP) 2007 data were analyzed. Logistic regression was used to
identify risk factors for cervical spine injury and test for interaction between age and
injury mechanism.


Results: In motor vehicle traffic injuries, older age groups had significantly higher odds
of cervical spine injury (OR: 1.44, 95% CI: 1.27, 1.64), but, in fall injuries, age did not
have a significant effect. Skull/face fractures, other spine fracture/dislocation, upper limb
injury, thorax injury and hypotension in emergency department were significantly
associated with cervical spine injury. Pelvic injuries had a protective effect (OR: 0.63,
95% CI: 0.56, 0.70). Black or African Americans were associated with significantly
higher odds of cervical spine injury compared to Whites in motor vehicle traffic injuries.
Other races for motor vehicle traffic injuries and Asians for fall injuries had significantly
lower odds.


Conclusion: These identified risk factors can inform physicians in evaluating cervical
spine injuries among patients with TBI.

Table of Contents

TABLE OF CONTENTS

INTRODUCTION AND BACKGROUND...1-4
METHODS...5-7
RESULTS...8-13
DISCUSSION...14-18
REFERENCES...19-21
TABLES...22-30

LIST OF TABLES

TABLE 1.Characteristics of traumatic brain injury cases (n=187,709), National Trauma
Data Bank National Sample Project, 2007...22
TABLE 2. Proportion of injury mechanism by age group among all traumatic brain injury
cases (n=187,709), cases with cervical spine injury (n=16,078) and cases without cervical
spine injury (n=171,631), National Trauma Data Bank National Sample Project, 2007 ... 24
TABLE 3. Univariate analysis of the association between potential risk factors and
cervical spine injury among traumatic brain injury cases (n=187,709), National Trauma
Data Bank National Sample Project, 2007...25
TABLE 4. Multiple logistic regression analysis of the association between potential risk
factors and cervical spine injury among traumatic brain injury cases (n=187,709),
National Trauma Data Bank National Sample Project, 2007...27
TABLE 5. Multiple logistic regression analysis of the association between potential risk
factors and cervical spine injury among motor vehicle traffic injuries (n=82,046) and fall
injuries (n=60,143), National Trauma Data Bank National Sample Project, 2007...29

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