Fracture characteristics predict patient mortality after blunt force cervical trauma.
Fractures of the cervical spine after blunt cervical trauma are associated with high rates of patient mortality. The purpose of this study was to investigate patient and fracture characteristics that predict mortality. This is a retrospective, case cohort study of all adult patients admitted to our institution between January 1998 and June 2008 with cervical fracture after blunt cervical trauma (N=218). All patient records were reviewed. The patient and fracture characteristics and outcome data were stored. Age (P=0.002), involvement of the fourth cervical vertebra (P=0.002), lamina fracture (P=0.001), and a facet fracture (P=0.006) were identified as independent significant risk factors for mortality. In conclusion, mortality is highly affected by patient age, but fracture location and fracture pattern are also predictive of poor patient outcome. Fracture patterns may increase the risk of spinal cord injury at a level that can affect but not eliminate neural control of the diaphragm, which have the worst prognosis for patient mortality.
Pull ter Gunne
Albert F
AF
Department of Orthopaedic Surgery, Johns Hopkins Hospital, Baltimore, Maryland 21287, USA. albert@pulltergunne.nl
Skolasky
Richard L
RL
Cohen
David B
DB
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002574:Cervical Vertebrae / Q000293:injuries*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D019838:Neck Injuries / Q000209:etiology / Q000401:mortality*; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D016103:Spinal Fractures / Q000209:etiology / Q000401:mortality*; D014481:United States; D014949:Wounds, Nonpenetrating / Q000150:complications / Q000401:mortality*; D055815:Young Adult