Risk factors predicting mortality after blunt traumatic cervical fracture.
OBJECTIVE
Risk factors for mortality after blunt cervical trauma have received little attention within the literature. Therefore, we performed a study, to determine which factors are associated with mortality in patients with blunt cervical trauma.


METHODS
A retrospective study of 88 trauma patients, with cervical fractures, who were admitted to the emergency department of the St. Elisabeth hospital, Tilburg, The Netherlands.


BACKGROUND
A retrospective cohort study was performed within the trauma department of the St. Elisabeth Hospital, in Tilburg, The Netherlands. From January 2000 to December 2005, all patients with cervical fractures after blunt trauma were included (N=88). All patient records were reviewed. Patient and trauma characteristics were registered within a standardised electronic database. Our follow-up period was 1 year.


RESULTS
In total, 12 (13.6%) patients died after a traumatic cervical fracture. Age (p=0.005), gender (p=0.005), involvement of the third cervical vertebrae (p=0.003), involvement of three cervical vertebrae (p=0.010) and involvement of the spinous process (p=0.032) were associated with mortality. The multivariate analysis showed that age and the involvement of the third cervical vertebrae (both p=0.016) are both independently associated with mortality.


CONCLUSIONS
Age and involvement of the third cervical vertebrae were both independent predictors of mortality. Age has been previously described as a risk factor for adverse prognosis in different diseases and trauma's. However, involvement of the third cervical vertebrae has not yet been described as a significant risk factor. Before implementation within trauma support further research is needed to evaluate the role of the third cervical vertebra regarding adverse prognosis and mortality in trauma patients.
Pull ter Gunne
Albert F
AF
Department of Surgery, St. Elisabeth Hospital, Tilburg, The Netherlands. albert@pulltergunne.nl
Aquarius
Annelies E
AE
Roukema
Jan-Anne
JA
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002574:Cervical Vertebrae / Q000293:injuries*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D011379:Prognosis; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D016103:Spinal Fractures / Q000401:mortality* / Q000628:therapy; D016019:Survival Analysis; D015599:Trauma Severity Indices; D014949:Wounds, Nonpenetrating / Q000401:mortality* / Q000628:therapy; D055815:Young Adult