Risk factors for cervical spine injury among patients with traumatic brain injury Open Access
Fujii, Tomoko (2011)
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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