title: Quantifying the Risk of Spinal Injury in Motor Vehicle Collisions According to Ambulatory Status: A Prospective Analytical Study.
abstract: BACKGROUND
  The association between ambulation at the scene of a motor vehicle collision (MVC) and spinal injury has never been quantified.
  
  
  OBJECTIVE
  To evaluate the association between ambulation and spinal injury in patients involved in a MVC.
  
  
  METHODS
  Prospective analytical-observational cohort study. Inclusion: patients sustaining traumatic injury in a MVC. Exclusion: < 18 years old, pregnancy.
  
  
  METHODS
  spinal injury defined as injury to the cervical, thoracic, or lumbar spinal cord, bones, or ligaments. Secondary outcome: Injury resulting in neurological deficit, need for surgery, or death. A generalized linear model was used to evaluate the association between outcome and predictor variables. Risk ratios [RR] were reported with a point estimate and 95% confidence interval (CI). A two-tailed alpha of < 0.05 was the threshold for statistical significance.
  
  
  RESULTS
  There were 704 patients analyzed. Nonambulatory patients were 2.29 times more likely to sustain a spinal injury, compared to ambulatory patients (RR 2.29, 95% CI 1.34-3.91). Patients ≥ 65 years of age were 3.27 times more likely to sustain a spinal injury (RR 3.27, 95% CI 1.66-6.45). Patients with a Glasgow Coma Scale score ≤ 8 were 4.93 times more likely to sustain a spinal injury (RR 4.93, 95% CI 1.86-13.10).
  
  
  CONCLUSIONS
  In this prospective analytical-observational study evaluating the association between ambulatory status and spinal injury in patients involved in MVCs, we observed that those patients who were nonambulatory were more than two times as likely to have a spinal injury compared to those patients who were ambulatory at the scene.
authors: Department of Emergency Medicine, University of California, Irvine, Orange, California.
authors: Christopher Eric
authors: CE
authors: McCoy
authors: Department of Emergency Medicine, University of California, Irvine, Orange, California.
authors: Angelica
authors: A
authors: Loza-Gomez
authors: Department of Emergency Medicine, University of California, Irvine, Orange, California.
authors: James
authors: J
authors: Lee Puckett
authors: Department of Emergency Medicine, University of California, Irvine, Orange, California.
authors: Samantha
authors: S
authors: Costantini
authors: Department of Emergency Medicine, University of California, Irvine, Orange, California.
authors: Patrick
authors: P
authors: Penalosa
authors: Department of Emergency Medicine, University of California, Irvine, Orange, California.
authors: Craig
authors: C
authors: Anderson
authors: Department of Emergency Medicine, University of California, Irvine, Orange, California.
authors: Carl
authors: C
authors: Schultz
mesh_terms: D000063:Accidents, Traffic / Q000706:statistics & numerical data*; D000293:Adolescent; D000328:Adult; D000368:Aged; D002140:California; D015331:Cohort Studies; D005260:Female; D015600:Glasgow Coma Scale / Q000706:statistics & numerical data; D006801:Humans; D007103:Immobilization / Q000379:methods / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D018986:Motor Vehicles / Q000706:statistics & numerical data; D016017:Odds Ratio; D011446:Prospective Studies; D012306:Risk; D013124:Spinal Injuries / Q000453:epidemiology*; D016138:Walking / Q000706:statistics & numerical data*
keywords: ambulatory status; motor vehicle collision; spinal immobilization; spinal injury; spinal motion restrictions