Survival among patients with severe high cervical spine injuries – a TraumaRegister DGU® database study
Abstract Background Trauma is a significant cause of death and impairment. The Abbreviated Injury Scale (AIS) differentiates the severity of trauma and is the basis for different trauma scores and prediction models. While the majority of patients do not survive injuries which are coded with an AIS 6...
Main Authors: | , , , , , , , , |
---|---|
Format: | Article |
Language: | English |
Published: |
BMC
2021-01-01
|
Series: | Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine |
Subjects: | |
Online Access: | https://doi.org/10.1186/s13049-020-00820-y |
id |
doaj-4be07221f61743bb9b48d41cd62acdb9 |
---|---|
record_format |
Article |
spelling |
doaj-4be07221f61743bb9b48d41cd62acdb92021-01-10T13:02:04ZengBMCScandinavian Journal of Trauma, Resuscitation and Emergency Medicine1757-72412021-01-012911810.1186/s13049-020-00820-ySurvival among patients with severe high cervical spine injuries – a TraumaRegister DGU® database studyO. Kamp0O. Jansen1R. Lefering2M. Aach3C. Waydhas4M. Dudda5T. A. Schildhauer6U. Hamsen7the TraumaRegister DGU8Department of Trauma, University Hospital Essen, Hand and Reconstructive, Surgery, University of Duisburg-EssenDepartment of General and Trauma Surgery, BG University Hospital BergmannsheilInstitute for Research in Operative Medicine (IFOM), University Witten/HerdeckeDepartment of Spinal Cord Injury, BG University Hospital BergmannsheilDepartment of General and Trauma Surgery, BG University Hospital BergmannsheilDepartment of Trauma, University Hospital Essen, Hand and Reconstructive, Surgery, University of Duisburg-EssenDepartment of General and Trauma Surgery, BG University Hospital BergmannsheilDepartment of General and Trauma Surgery, BG University Hospital BergmannsheilCommittee on Emergency Medicine, Intensive Care and Trauma Management (Section NIS) of the German Trauma Society (DGU)Abstract Background Trauma is a significant cause of death and impairment. The Abbreviated Injury Scale (AIS) differentiates the severity of trauma and is the basis for different trauma scores and prediction models. While the majority of patients do not survive injuries which are coded with an AIS 6, there are several patients with a severe high cervical spinal cord injury that could be discharged from hospital despite the prognosis of trauma scores. We estimate that the trauma scores and prediction models miscalculate these injuries. For this reason, we evaluated these findings in a larger control group. Methods In a retrospective, multi-centre study, we used the data recorded in the TraumaRegister DGU® (TR-DGU) to select patients with a severe cervical spinal cord injury and an AIS of 3 to 6 between 2002 to 2015. We compared the estimated mortality rate according to the Revised Injury Severity Classification II (RISC II) score against the actual mortality rate for this group. Results Six hundred and twelve patients (0.6%) sustained a severe cervical spinal cord injury with an AIS of 6. The mean age was 57.8 ± 21.8 years and 441 (72.3%) were male. 580 (98.6%) suffered a blunt trauma, 301 patients were injured in a car accident and 29 through attempted suicide. Out of the 612 patients, 391 (63.9%) died from their injury and 170 during the first 24 h. The group had a predicted mortality rate of 81.4%, but we observed an actual mortality rate of 63.9%. Conclusions An AIS of 6 with a complete cord syndrome above C3 as documented in the TR-DGU is survivable if patients get to the hospital alive, at which point they show a survival rate of more than 35%. Compared to the mortality prognosis based on the RISC II score, they survived much more often than expected.https://doi.org/10.1186/s13049-020-00820-yCervical spinal cord injuryInjury severity score (ISS)Abbreviated injury scale (AIS)Revised injury severity classification II (RISC II)OutcomeTrauma register |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
O. Kamp O. Jansen R. Lefering M. Aach C. Waydhas M. Dudda T. A. Schildhauer U. Hamsen the TraumaRegister DGU |
spellingShingle |
O. Kamp O. Jansen R. Lefering M. Aach C. Waydhas M. Dudda T. A. Schildhauer U. Hamsen the TraumaRegister DGU Survival among patients with severe high cervical spine injuries – a TraumaRegister DGU® database study Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine Cervical spinal cord injury Injury severity score (ISS) Abbreviated injury scale (AIS) Revised injury severity classification II (RISC II) Outcome Trauma register |
author_facet |
O. Kamp O. Jansen R. Lefering M. Aach C. Waydhas M. Dudda T. A. Schildhauer U. Hamsen the TraumaRegister DGU |
author_sort |
O. Kamp |
title |
Survival among patients with severe high cervical spine injuries – a TraumaRegister DGU® database study |
title_short |
Survival among patients with severe high cervical spine injuries – a TraumaRegister DGU® database study |
title_full |
Survival among patients with severe high cervical spine injuries – a TraumaRegister DGU® database study |
title_fullStr |
Survival among patients with severe high cervical spine injuries – a TraumaRegister DGU® database study |
title_full_unstemmed |
Survival among patients with severe high cervical spine injuries – a TraumaRegister DGU® database study |
title_sort |
survival among patients with severe high cervical spine injuries – a traumaregister dgu® database study |
publisher |
BMC |
series |
Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine |
issn |
1757-7241 |
publishDate |
2021-01-01 |
description |
Abstract Background Trauma is a significant cause of death and impairment. The Abbreviated Injury Scale (AIS) differentiates the severity of trauma and is the basis for different trauma scores and prediction models. While the majority of patients do not survive injuries which are coded with an AIS 6, there are several patients with a severe high cervical spinal cord injury that could be discharged from hospital despite the prognosis of trauma scores. We estimate that the trauma scores and prediction models miscalculate these injuries. For this reason, we evaluated these findings in a larger control group. Methods In a retrospective, multi-centre study, we used the data recorded in the TraumaRegister DGU® (TR-DGU) to select patients with a severe cervical spinal cord injury and an AIS of 3 to 6 between 2002 to 2015. We compared the estimated mortality rate according to the Revised Injury Severity Classification II (RISC II) score against the actual mortality rate for this group. Results Six hundred and twelve patients (0.6%) sustained a severe cervical spinal cord injury with an AIS of 6. The mean age was 57.8 ± 21.8 years and 441 (72.3%) were male. 580 (98.6%) suffered a blunt trauma, 301 patients were injured in a car accident and 29 through attempted suicide. Out of the 612 patients, 391 (63.9%) died from their injury and 170 during the first 24 h. The group had a predicted mortality rate of 81.4%, but we observed an actual mortality rate of 63.9%. Conclusions An AIS of 6 with a complete cord syndrome above C3 as documented in the TR-DGU is survivable if patients get to the hospital alive, at which point they show a survival rate of more than 35%. Compared to the mortality prognosis based on the RISC II score, they survived much more often than expected. |
topic |
Cervical spinal cord injury Injury severity score (ISS) Abbreviated injury scale (AIS) Revised injury severity classification II (RISC II) Outcome Trauma register |
url |
https://doi.org/10.1186/s13049-020-00820-y |
work_keys_str_mv |
AT okamp survivalamongpatientswithseverehighcervicalspineinjuriesatraumaregisterdgudatabasestudy AT ojansen survivalamongpatientswithseverehighcervicalspineinjuriesatraumaregisterdgudatabasestudy AT rlefering survivalamongpatientswithseverehighcervicalspineinjuriesatraumaregisterdgudatabasestudy AT maach survivalamongpatientswithseverehighcervicalspineinjuriesatraumaregisterdgudatabasestudy AT cwaydhas survivalamongpatientswithseverehighcervicalspineinjuriesatraumaregisterdgudatabasestudy AT mdudda survivalamongpatientswithseverehighcervicalspineinjuriesatraumaregisterdgudatabasestudy AT taschildhauer survivalamongpatientswithseverehighcervicalspineinjuriesatraumaregisterdgudatabasestudy AT uhamsen survivalamongpatientswithseverehighcervicalspineinjuriesatraumaregisterdgudatabasestudy AT thetraumaregisterdgu survivalamongpatientswithseverehighcervicalspineinjuriesatraumaregisterdgudatabasestudy |
_version_ |
1724341855402852352 |