title: Abdominal hollow viscus injuries are associated with spine and neurologic infections after penetrating spinal cord injuries.
abstract: Penetrating spinal cord injuries are rare but potentially devastating injuries that are associated with significant morbidity. The objective of this study was to assess the impact of abdominal hollow viscus injuries (HVIs) on neurologic and spinal infectious complications in patients sustaining penetrating spinal cord injuries. We performed a 13-year retrospective review of a Level I trauma center database. Variables analyzed included demographics, injury patterns and severity, spine operations, and outcomes. Spine and neurologic infections (SNIs) were defined as paraspinal or spinal abscess, osteomyelitis, and meningitis. Multivariate analysis was performed to identify factors associated with SNI. Of 137 patients, there were 126 males (92%) with a mean age of 27 ± 10 years. Eight patients (6%) underwent operative stabilization of their spine. Fifteen patients (11%) developed SNI. There was a higher incidence of SNI among patients with abdominal HVI compared with those without (eight [26%] vs six [6%], P < 0.001). On multivariate analysis, after controlling for injury severity, solid abdominal injury and HVI, vascular injury, and spine operation, abdominal HVIs were independently associated with an increased risk for SNI (odds ratio, 6.88; 95% confidence interval, 2.14 to 22.09; P = 0.001). Further studies are required to determine the optimal management strategy to prevent and successfully treat these infections.
authors.affiliation: Division of Trauma/Acute Care Surgery/Surgical Critical Care, Department of Surgery, Harbor-UCLA Medical Center, Torrance, California.
authors.forename: Alexander C
authors.initials: AC
authors.lastname: Schwed
authors.forename: David S
authors.initials: DS
authors.lastname: Plurad
authors.forename: Scott
authors.initials: S
authors.lastname: Bricker
authors.forename: Angela
authors.initials: A
authors.lastname: Neville
authors.forename: Fred
authors.initials: F
authors.lastname: Bongard
authors.forename: Brant
authors.initials: B
authors.lastname: Putnam
authors.forename: Dennis Y
authors.initials: DY
authors.lastname: Kim
mesh_terms: D000007:Abdominal Injuries / Q000150:complications*; D000038:Abscess / Q000453:epidemiology / Q000209:etiology*; D000293:Adolescent; D015331:Cohort Studies; D005260:Female; D006801:Humans; D015994:Incidence; D016015:Logistic Models; D008297:Male; D008581:Meningitis / Q000453:epidemiology / Q000209:etiology*; D015999:Multivariate Analysis; D010019:Osteomyelitis / Q000453:epidemiology / Q000209:etiology*; D012189:Retrospective Studies; D012307:Risk Factors; D013119:Spinal Cord Injuries / Q000150:complications*; D013122:Spinal Diseases / Q000453:epidemiology / Q000209:etiology*; D014950:Wounds, Penetrating / Q000150:complications*; D055815:Young Adult