The Outcome of Cervical Spine Injury Associated with Traumatic Brain Injuries: Tertiary Care Hospital Study

Objective: Outcome of cervical spine injury associated with traumatic brain injuries. Materials & Methods: This study is a cross-sectional descriptive study that was performed at the Jinnah Post Graduate Medical Centre, Karachi. 158 total patients were included in the study, this study by non-probability consecutive sampling. The diagnosis was based primarily on a CT scan brain plain and an x-ray of the cervical spine of all the patients who were admitted to the ward. Results: Among 158, the age distribution of the patient was observed as 43(27%)patients presented as less than 20 years, 32(20%) were between the age of 21-30 years range, 28(18%) patients were ranged between 31-40 years, 16(10%) patients aged in a range of 41-50 years while 39(25%) were above 50 years. Head injury severity was observed at 47% as mild head injury, 32% as moderate injury and 21% had a severe head injury while cervical injury in association with traumatic brain injury was found in 10% of patients. Conclusion: The prevalence of cervical traumatic injury associated with moderate to severe head injury remained similar in the world overall with minute differences in the percentages that we have noticed in our study. The severity of the head injury is directly proportional to cervical injury.

Risk Factors for Cervical Spine Injury in an Obtunded Blunt Trauma Patient

Background: In Thailand, many hospitals cannot send every obtunded blunt trauma patient for cervical spine CT scan because of the socioeconomic status. Knowing about the risk factors for cervical spine injury in an obtunded blunt trauma patient would help the clinician monitor for cervical spine injury. Objective: To identify the risk factors of cervical spine injury in an obtunded blunt trauma patient. Materials and Methods: The present study evaluated 400 obtunded blunt trauma patients with a GCS of less than 15, in the trauma center of Srinagarind Hospital between January 2015 and December 2019. The patients were chosen from the patient’s registry for the present retrospective cross-sectional study. A univariate analysis was fulfilled with potential risk factors such as age, gender, mechanism of injury, GCS, associated injury, and intracranial lesion. Then, multivariate analysis was used to identify the risk factors of cervical spine injury in obtunded blunt trauma patients. Results: Four hundred patients were included in the present study. Eighty-eight (22%, 95% CI 18.04 to 26.38) had a cervical spine injury. The mean age was 40.04 years, 73% were males with a male to female ratio of 2.7 to 1. For the mechanisms of injury, 66% of injuries resulted from motorcycle accidents, 15% from car accidents, and 14% from falls. From univariate analysis, age older than 60 years had significant higher odds of cervical spine injury than age younger than 60 years (OR 1.93, 95% CI 1.05 to 3.54). Thoracic spine fracture had significant higher odds of cervical spine injury than other associate injuries (OR 6.2, 95% CI 1.45 to 26.5). From multivariate analysis, age older than 60 years had significant higher odds of cervical spine injury than age younger than 60 years (aOR 1.99, 95% CI 1.07 to 3.68). Thoracic spine fracture had a significantly higher odds of cervical spine injury than the other associated injuries (aOR 6.4, 95% CI 1.48 to 27.63). In patients age older than 60 years, 42% of cervical spine injuries occurred from fall. Conclusion: From the present study, age older than 60 years and thoracic spine fracture are the significant risk factors of cervical spine injury in obtunded blunt trauma patients. Keywords: Cervical spine injury; Risk factors; Obtunded blunt trauma patient