The effect of polytrauma in persons with traumatic spine injury. A prospective database of spine fractures.
METHODS
A mixed cross-sectional survey and cohort study using a prospectively gathered database of persons with traumatic spine injury.


OBJECTIVE
To identify demographic and injury mechanism factors that predict greater injury severity, and to determine the effect of injury severity on outcomes in traumatic spine fracture.


BACKGROUND
Traumatic spine fracture outcome studies have focused on defining type and level of vertebral fracture without considering the severity of associated injuries. In the trauma population, greater injury severity has been shown to be related to worse outcome. No studies have been reported on the effect of injury severity on outcome in the traumatic spine fracture population.


METHODS
Prospectively collected data on 830 persons with traumatic spine injury who were admitted to a trauma hospital were reviewed. Patient demographics; injury mechanism; hospital events; and disability, employment, and pain status at discharge, 1 year, and 2 years after injury were recorded. Associations between these factors and trauma severity (Injury Severity Score) were explored using Pearson's correlation and analysis of variance.


RESULTS
Trauma was more severe in patients who had been married previously, who were involved in a motor vehicle accident, were ejected from the vehicle, had loss of consciousness, had higher-level and multiple complicated vertebral fractures, or had neurologic deficit. Those more severely injured had longer lengths of stay, more surgery, more complications, higher mortality, more disability, and less return to work.


CONCLUSIONS
Persons with traumatic spine injury and polytrauma have poorer short- and long-term outcomes. This high-risk group may require aggressive interventions, more hospital resources, and close follow-up observation after discharge from hospital to optimize outcome.
Hebert
J S
JS
Physical Medicine and Rehabilitation Department, University of Alberta, Glenrose Rehabilitation Hospital, Edmonton. jhebert@gpu.srv.ualberta.ca
Burnham
R S
RS
D000063:Accidents, Traffic; D000293:Adolescent; D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D016208:Databases, Factual; D005260:Female; D006801:Humans; D015601:Injury Severity Score; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D009104:Multiple Trauma / Q000209:etiology / Q000503:physiopathology*; D017063:Outcome Assessment, Health Care; D011237:Predictive Value of Tests; D011446:Prospective Studies; D013124:Spinal Injuries / Q000453:epidemiology / Q000503:physiopathology*