Assessing Incidence and Risk Factors of Cervical Spine Injury in Blunt Trauma Patients Using the National Trauma Data Bank

2015 ◽  
Vol 81 (9) ◽  
pp. 879-883 ◽  
Author(s):  
Andrew J. Young ◽  
Luke Wolfe ◽  
Glenn Tinkoff ◽  
Therese M. Duane
Keyword(s):  
Risk Factors ◽  
Cervical Spine ◽  
Injury Severity Score ◽  
Blunt Trauma ◽  
Severity Score ◽  
Injury Severity ◽  
Alcohol Intoxication ◽  
Spine Injury ◽  
Ligamentous Injury ◽  
National Trauma

Despite the potentially devastating impact of missed cervical spine injuries (CI), there continues to be a large disparity in how institutions attempt to make the diagnosis. To better streamline the approach among institutions, understanding incidence and risk factors across the country is paramount. We evaluated the incidence and risk factors of CI using the National Trauma Databank for 2008 and 2009. We performed a retrospective review of the National Trauma Databank for 2008 and 2009 comparing patients with and without CI. We then performed subset analysis separating injury by patients with and without fracture and ligamentous injury. There were a total of 591,138 patients included with a 6.2 per cent incidence of CI. Regression found that age, Injury Severity Score, alcohol intoxication, and specific mechanisms of motor vehicle crash (MVC), motorcycle crash (MCC), fall, pedestrian stuck, and bicycle were independent risk factors for overall injury ( P < 0.0001). Patients with CI had longer intensive care unit (8.5 12.5 vs 5.1 7.7) and hospital lengths of stay (days) (9.6 14.2 vs 5.3 8.1) and higher mortality (1.2 per cent vs 0.3%), compared with those without injury ( P < 0.0001). There were 33,276 patient with only fractures for an incidence of 5.6 per cent and 1875 patients with ligamentous injury. Just over 6 per cent of patients suffer some form of CI after blunt trauma with the majority being fractures. Higher Injury Severity Score and MVC were consistent risk factors in both groups. This information will assist in devising an algorithm for clearance that can be used nationally allowing for more consistency among trauma providers.

Cervical Spine Injury Severity Score

2007 ◽  
Vol 89 (5) ◽  
pp. 1057-1065 ◽  
Author(s):  
Paul A. Anderson ◽  
Timothy A. Moore ◽  
Kirkland W. Davis ◽  
Robert W. Molinari ◽  
Daniel K. Resnick ◽  
...  
Keyword(s):  
Cervical Spine ◽  
Injury Severity Score ◽  
Severity Score ◽  
Cervical Spine Injury ◽  
Injury Severity ◽  
Spine Injury

Cervical Spine Injury Severity Score

2007 ◽  
Vol 89 (5) ◽  
pp. 1057-1065 ◽  
Author(s):  
Paul A. Anderson ◽  
Timothy A. Moore ◽  
Kirkland W. Davis ◽  
Robert W. Molinari ◽  
Daniel K. Resnick ◽  
...  
Keyword(s):  
Cervical Spine ◽  
Injury Severity Score ◽  
Severity Score ◽  
Cervical Spine Injury ◽  
Injury Severity ◽  
Spine Injury

scholarly journals External Multicenter Study of Reliability and Reproducibility for Lower Cervical Spine Injuries Classification Systems—Part 2: An Analysis of the Subaxial Cervical Spine Injury Classification and Cervical Spine Injury Severity Score Scale

2019 ◽  
Vol 11 (1) ◽  
pp. 99-107
Author(s):  
Andrey Grin ◽  
Vladimir Krylov ◽  
Ivan Lvov ◽  
Aleksandr Talypov ◽  
Dmitriy Dzukaev ◽  
...  
Keyword(s):  
Cervical Spine ◽  
Injury Severity Score ◽  
Severity Score ◽  
Cervical Spine Injury ◽  
Injury Severity ◽  
Moderate Level ◽  
Spine Injury ◽  
Subaxial Cervical Spine ◽  
Level Of Agreement ◽  
Injury Classification

Study Design: A multicenter observational survey. Objective: To quantify and compare inter- and intraobserver reliability of the subaxial cervical spine injury classification (SLIC) and the cervical spine injury severity score (CSISS) in a multicentric survey of neurosurgeons with different experience levels. Methods: Data concerning 64 consecutive patients who had undergone cervical spine surgery between 2013 and 2017 was evaluated, and we surveyed 37 neurosurgeons from 7 different clinics. All raters were divided into 3 groups depending on their level of experience. Two assessment procedures were performed. Results: For the SLIC, we observed excellent agreement regarding management among experienced surgeons, whereas agreement among less experienced neurosurgeons was moderate and almost twice as unlikely. The sensitivity of SLIC relating to treatment tactics reached as high as 92.2%. For the CSISS, agreement regarding management ranged from medium to substantial, depending on a neurosurgeon’s experience. For less experienced neurosurgeons, the level of agreement concerning surgical management was the same as for the SLIC in not exceeding a moderate level. However, this scale had insufficient sensitivity (slightly exceeding 50%). The reproducibility of both scales was excellent among all raters regardless of their experience level. Conclusions: Our study demonstrated better management reliability, sensitivity, and reproducibility for the SLIC, which provided moderate interrater agreement with moderate to excellent intraclass correlation coefficient indicators for all raters. The CSISS demonstrated high reproducibility; however, large variability in answers prevented raters from reaching a moderate level of agreement. Magnetic resonance imaging integration may increase sensitivity of CSISS in relation to fracture management.

scholarly journals The Applicability of Trauma and Injury Severity Score for a Blunt Trauma Population in Korea and a Proposal of New Models Using Score Predictors

2016 ◽  
Vol 57 (3) ◽  
pp. 728 ◽  
Author(s):  
Kyoungwon Jung ◽  
Yo Huh ◽  
John Cook-Jong Lee ◽  
Younghwan Kim ◽  
Jonghwan Moon ◽  
...  
Keyword(s):  
Injury Severity Score ◽  
Blunt Trauma ◽  
Severity Score ◽  
Injury Severity ◽  
Trauma Population ◽  
New Models ◽  
Trauma And Injury

Epidemiology of Traumatic Esophageal Injury: An Analysis of the National Trauma Data Bank

2019 ◽  
Vol 85 (4) ◽  
pp. 342-349 ◽  
Author(s):  
Alexander A. Xu ◽  
Janis L. Breeze ◽  
Jessica K. Paulus ◽  
Nikolay Bugaev
Keyword(s):  
Injury Severity Score ◽  
Severity Score ◽  
Injury Severity ◽  
Traumatic Injury ◽  
Data Bank ◽  
Esophageal Injury ◽  
Trauma Patients ◽  
Adult Age ◽  
National Trauma ◽  
National Trauma Data Bank

Existing literature on traumatic injury of the esophagus (TIE) is limited. We aimed to describe the clinical characteristics and outcomes of TIE. We reviewed the National Trauma Data Bank for the years 2010–2015. We described the demographics, characteristics, and outcomes of adult (age ≥16 years) TIE patients and also compared those factors in blunt versus penetrating TIE. The association between TIE and mortality was analyzed using multivariable logistic regression. Thousand four hundred eleven adult TIE patients were identified (37 per 100,000 trauma patients, 95% confidence intervals (CI): 35, 39). TIE patients were younger (38 vs 52 years), more likely to be male (81% vs 62%), and more severely injured (Injury Severity Score ≥ 25: 45% vs 7%) than patients without TIE (all P < 0.001). TIE was observed 16 times more frequently with penetrating injuries (257 per 100,000, 95% CI: 240, 270) than with blunt injuries (16 per 100,000, 95% CI: 15, 18). Inhospital TIE mortality was 19 per cent. TIE patients had greater risk of mortality than other trauma patients, after adjusting for age, gender, and Injury Severity Score (odds ratio = 1.4, 95% CI: 1.1, 1.7). Mortality in blunt and penetrating TIE did not differ. Although extremely rare, TIE is independently associated with a marked increase in mortality, even after adjusting for other risk factors.

scholarly journals Validation of Age-specific Survival Prediction in Pediatric Patients With Blunt Trauma Using Trauma and Injury Severity Score Methodology: A Ten-year Nationwide Observational Study

2020 ◽  
Author(s):  
Chiaki Toida ◽  
Takashi Muguruma ◽  
Masayasu Gakumazawa ◽  
Mafumi Shinohara ◽  
Takeru Abe ◽  
...  
Keyword(s):  
Injury Severity Score ◽  
Blunt Trauma ◽  
Severity Score ◽  
Pediatric Patients ◽  
Injury Severity ◽  
Pediatric Trauma ◽  
Survival Prediction ◽  
Trauma Patients ◽  
Interval Group ◽  
Trauma And Injury

Abstract Background: In-hospital mortality in trauma patients decreased recently owing to improved trauma injury prevention systems. However, no study which evaluated the validity of Trauma and Injury Severity Score (TRISS) in pediatrics by detailed classification of patients’ age and injury severity in Japan. This retrospective nationwide study evaluated the validity of TRISS in predicting survival in Japanese pediatric patients with blunt trauma by age and injury severity.Methods: Data were obtained from the Japan Trauma Data Bank during 2009−2018.Results: In all age categories, the area under the curve (AUC) for TRISS demonstrated high performance (0.935, 0.981, 0.979, and 0.977). The Accuracy of TRISS was 99.9%, 98.2%, 92.1%, 76.7%, 55.3%, and 72.1% in survival probability (Ps) interval groups (0.96−1.00), (0.91−0.95), (0.76.−0.90), (0.51−0.75), (0.26−0.50), and (0.00−0.25), respectively. The AUC for TRISS demonstrated moderate performance in the Ps interval group (0.96−1.00) and low performance in other Ps interval groups.Conclusions: The TRISS methodology appears to predict survival accurately in Japanese pediatric patients with blunt trauma; however, there were several problems in adopting the TRISS methodology for younger blunt trauma patients with higher injury severity. In the future, we should consider to conducting a simple, high-quality prediction model that is more suitable for pediatric trauma patients than the current TRISS model.

Sign in / Sign up

Export Citation Format

Share Document