Cervical spine injury in burned trauma patients: Incidence, predictors, and outcomes

Laura A. Galganski, Jessica A. Cox, David G Greenhalgh, Soman Sen, Kathleen Romanowski, Tina L Palmieri

Research output: Contribution to journalArticle

Abstract

Cervical spine injuries (CIs) carry significant morbidity and mortality; hence, cervical spine immobilization is used liberally in trauma patients, including burns. The incidence, predictors, and outcomes of CI in burn patients are unknown. A retrospective cohort from the National Trauma Data Bank between 2007 and 2012 included all burned patients with and without CI. Predictors of CI were identified by logistic regression. Outcomes with and without CI were compared with Wilcoxon rank sum test. A total of 94,964 patients were identified with burn injuries. The incidence of CI was 0.79% (n = 745). Mechanism of injury, age, and injury severity score (ISS) were significant predictors of CI. Odds of CI were 109.4 (95% CI: 61.2-195.3, P < .0001) for motor vehicle injury, 87.8 (95% CI: 47.0-164.0, P < .0001) for falls, 1.2 (95% CI: 0.6-2.3, P = .66) for fire/flame, and 2.4 (95% CI: 1.0-5.5, P < .0001) for explosion compared with reference of hot object/substance. For every year increase in age, there were 1.02 higher odds of CI (95% CI: 1.01-1.02, P < .0001). For each point increase in ISS, there were 1.05 higher odds of CI (95% CI: 1.04-1.05, P < .0001). Patients with CI had higher mortality (10.3% vs 2.9%, P < .0001), longer total length of stay (12.0 vs 2.0 days, P < .0001), intensive care unit length of stay (4.0 vs 0.0 days, P < .001), and ventilator days (1.0 vs 0.0 days, P < .0001). The incidence of CI in burn patients is low, especially when due to fire, flame, or scalds; however, CI is associated with higher mortality and worse outcomes.

Original languageEnglish (US)
Pages (from-to)263-268
Number of pages6
JournalJournal of Burn Care and Research
Volume40
Issue number3
DOIs
StatePublished - Jan 1 2019

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Spine
Incidence
Wounds and Injuries
Injury Severity Score
Nonparametric Statistics
Mortality
Length of Stay
Explosions
Motor Vehicles
Mechanical Ventilators
Burns

ASJC Scopus subject areas

  • Surgery
  • Emergency Medicine
  • Rehabilitation

Cite this

Cervical spine injury in burned trauma patients : Incidence, predictors, and outcomes. / Galganski, Laura A.; Cox, Jessica A.; Greenhalgh, David G; Sen, Soman; Romanowski, Kathleen; Palmieri, Tina L.

In: Journal of Burn Care and Research, Vol. 40, No. 3, 01.01.2019, p. 263-268.

Research output: Contribution to journalArticle

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abstract = "Cervical spine injuries (CIs) carry significant morbidity and mortality; hence, cervical spine immobilization is used liberally in trauma patients, including burns. The incidence, predictors, and outcomes of CI in burn patients are unknown. A retrospective cohort from the National Trauma Data Bank between 2007 and 2012 included all burned patients with and without CI. Predictors of CI were identified by logistic regression. Outcomes with and without CI were compared with Wilcoxon rank sum test. A total of 94,964 patients were identified with burn injuries. The incidence of CI was 0.79{\%} (n = 745). Mechanism of injury, age, and injury severity score (ISS) were significant predictors of CI. Odds of CI were 109.4 (95{\%} CI: 61.2-195.3, P < .0001) for motor vehicle injury, 87.8 (95{\%} CI: 47.0-164.0, P < .0001) for falls, 1.2 (95{\%} CI: 0.6-2.3, P = .66) for fire/flame, and 2.4 (95{\%} CI: 1.0-5.5, P < .0001) for explosion compared with reference of hot object/substance. For every year increase in age, there were 1.02 higher odds of CI (95{\%} CI: 1.01-1.02, P < .0001). For each point increase in ISS, there were 1.05 higher odds of CI (95{\%} CI: 1.04-1.05, P < .0001). Patients with CI had higher mortality (10.3{\%} vs 2.9{\%}, P < .0001), longer total length of stay (12.0 vs 2.0 days, P < .0001), intensive care unit length of stay (4.0 vs 0.0 days, P < .001), and ventilator days (1.0 vs 0.0 days, P < .0001). The incidence of CI in burn patients is low, especially when due to fire, flame, or scalds; however, CI is associated with higher mortality and worse outcomes.",
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