Critical Care: Miscellaneous Critical Care |

Cervical Spine Injury Without Neurologic Deficit vs Thoracic or Lumbar Spine Injury: Does Location Matter With Regard to Complications? FREE TO VIEW

Krishna Akella, DO; Akella Chendrasekhar, MD
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Richmond University Medical Center, Staten Island, NY

Copyright 2016, American College of Chest Physicians. All Rights Reserved.

Chest. 2016;150(4_S):336A. doi:10.1016/j.chest.2016.08.349
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SESSION TITLE: Miscellaneous Critical Care

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Wednesday, October 26, 2016 at 01:30 PM - 02:30 PM

PURPOSE: Spinal injury in the absence of neurologic deficit is a common cause of morbidity in trauma patients. As neurologic injury is the most common cause of death in trauma patients, initial evaluation involves differentiating spinal column injury with and without neurologic deficit. At our trauma center, we studied association of location of spinal injury without neurologic deficit with the development of complications.

METHODS: A retrospective data analysis was performed on patients with spinal injury without neurologic deficit. Data obtained included location of injury, age, Injury Severity Score (ISS), ICU length of stay, hospital length of stay, intubation, ventilator days, pulmonary infection, and survival. Data were analyzed with One-way analysis of variance (ANOVA).

RESULTS: 203 patients were enrolled, 95 women and 108 men. Location of the spinal injury was broken down into three categories: 76 cervical spine injury, 43 thoracic spine injury and 84 lumbar spine injury. The mean age was 57.5 years. Complication rates were found to be greater in cervical spine injury as compared to thoracic and lumbar, with regard to ICU length of stay (days) (5.7 vs. 0.9 vs. 1.0, p = 0.0007), hospital length of stay (days) (12.2 vs. 5.7 vs. 5.1, p = 0.0006), number of ventilator days (3.7 vs. 0.2 vs. 0.1, p = 0.0104), and incidence of pulmonary infection (%) (46 vs. 14 vs. 10, p< 0.0001). Difference in ISS, intubation rate, and survival was found to be insignificant.

CONCLUSIONS: Of the patients with cervical injury in the absence of neurologic deficit that were intubated, the incidence of pulmonary infection was greater than patients with thoracic or lumbar injury.

CLINICAL IMPLICATIONS: Cervical spine injury without neurologic deficit is associated with significant pulmonary complication.

DISCLOSURE: The following authors have nothing to disclose: Krishna Akella, Akella Chendrasekhar

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