caa a22 4500 445832266 CHVBK 20180317145319.0 cr unu---uuuuu 170323e20111201xx s 000 0 eng 10.1007/s00586-011-1866-7 doi (NATIONALLICENCE)springer-10.1007/s00586-011-1866-7 Epidemiology and predictors of spinal injury in adult major trauma patients: European cohort study [Elektronische Daten] [Rebecca Hasler, Aristomenis Exadaktylos, Omar Bouamra, Lorin Benneker, Mike Clancy, Robert Sieber, Heinz Zimmermann, Fiona Lecky] This is a European cohort study on predictors of spinal injury in adult (≥16years) major trauma patients, using prospectively collected data of the Trauma Audit and Research Network from 1988 to 2009. Predictors for spinal fractures/dislocations or spinal cord injury were determined using univariate and multivariate logistic regression analysis. 250,584 patients were analysed. 24,000 patients (9.6%) sustained spinal fractures/dislocations alone and 4,489 (1.8%) sustained spinal cord injury with or without fractures/dislocations. Spinal injury patients had a median age of 44.5years (IQR=28.8-64.0) and Injury Severity Score of 9 (IQR=4-17). 64.9% were male. 45% of patients suffered associated injuries to other body regions. Age <45years (≥45 years OR 0.83-0.94), Glasgow Coma Score (GCS) 3-8 (OR 1.10, 95% CI 1.02-1.19), falls >2m (OR 4.17, 95% CI 3.98-4.37), sports injuries (OR 2.79, 95% CI 2.41-3.23) and road traffic collisions (RTCs) (OR 1.91, 95% CI 1.83-2.00) were predictors for spinal fractures/dislocations. Age <45years (≥45 years OR 0.78-0.90), male gender (female OR 0.78, 95% CI 0.72-0.85), GCS <15 (OR 1.36-1.93), associated chest injury (OR 1.10, 95% CI 1.01-1.20), sports injuries (OR 3.98, 95% CI 3.04-5.21), falls >2m (OR 3.60, 95% CI 3.21-4.04), RTCs (OR 2.20, 95% CI 1.96-2.46) and shooting (OR 1.91, 95% CI 1.21-3.00) were predictors for spinal cord injury. Multilevel injury was found in 10.4% of fractures/dislocations and in 1.3% of cord injury patients. As spinal trauma occurred in >10% of major trauma patients, aggressive evaluation of the spine is warranted, especially, in males, patients <45 years, with a GCS <15, concomitant chest injury and/or dangerous injury mechanisms (falls >2m, sports injuries, RTCs and shooting). Diagnostic imaging of the whole spine and a diligent search for associated injuries are substantial. The Author(s), 2011 Spinal cord injury nationallicence Spinal fractures/dislocations nationallicence TARN registry nationallicence Major trauma nationallicence Predictors nationallicence Hasler Rebecca Trauma Audit and Research Network (TARN), Health Sciences Research Group, School of Community Based Medicine, Manchester Academic Health Sciences Centre, University of Manchester, Salford Royal Hospital, Stott Lane, M6 8HD, Salford, UK aut Exadaktylos Aristomenis Department of Emergency Medicine, Inselspital, University Hospital Bern, Freiburgstr, 3010, Bern, Switzerland aut Bouamra Omar Trauma Audit and Research Network (TARN), Health Sciences Research Group, School of Community Based Medicine, Manchester Academic Health Sciences Centre, University of Manchester, Salford Royal Hospital, Stott Lane, M6 8HD, Salford, UK aut Benneker Lorin Department of Orthopedic Surgery, Inselspital, University Hospital Bern, Freiburgstr, 3010, Bern, Switzerland aut Clancy Mike Department of Emergency Medicine, Southampton University Hospitals Trust, Tremona Rd, SO 16 6YD, Southampton, UK aut Sieber Robert Department of Emergency Medicine, Cantonal Hospital, Rorschacherstrasse 9007 St., Gallen, Switzerland aut Zimmermann Heinz Department of Emergency Medicine, Inselspital, University Hospital Bern, Freiburgstr, 3010, Bern, Switzerland aut Lecky Fiona Trauma Audit and Research Network (TARN), Health Sciences Research Group, School of Community Based Medicine, Manchester Academic Health Sciences Centre, University of Manchester, Salford Royal Hospital, Stott Lane, M6 8HD, Salford, UK aut European Spine Journal Springer-Verlag 20/12(2011-12-01), 2174-2180 0940-6719 20:12<2174 2011 20 586 https://doi.org/10.1007/s00586-011-1866-7 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s00586-011-1866-7 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Hasler Rebecca Trauma Audit and Research Network (TARN), Health Sciences Research Group, School of Community Based Medicine, Manchester Academic Health Sciences Centre, University of Manchester, Salford Royal Hospital, Stott Lane, M6 8HD, Salford, UK aut NATIONALLICENCE 700 1- Exadaktylos Aristomenis Department of Emergency Medicine, Inselspital, University Hospital Bern, Freiburgstr, 3010, Bern, Switzerland aut NATIONALLICENCE 700 1- Bouamra Omar Trauma Audit and Research Network (TARN), Health Sciences Research Group, School of Community Based Medicine, Manchester Academic Health Sciences Centre, University of Manchester, Salford Royal Hospital, Stott Lane, M6 8HD, Salford, UK aut NATIONALLICENCE 700 1- Benneker Lorin Department of Orthopedic Surgery, Inselspital, University Hospital Bern, Freiburgstr, 3010, Bern, Switzerland aut NATIONALLICENCE 700 1- Clancy Mike Department of Emergency Medicine, Southampton University Hospitals Trust, Tremona Rd, SO 16 6YD, Southampton, UK aut NATIONALLICENCE 700 1- Sieber Robert Department of Emergency Medicine, Cantonal Hospital, Rorschacherstrasse 9007 St., Gallen, Switzerland aut NATIONALLICENCE 700 1- Zimmermann Heinz Department of Emergency Medicine, Inselspital, University Hospital Bern, Freiburgstr, 3010, Bern, Switzerland aut NATIONALLICENCE 700 1- Lecky Fiona Trauma Audit and Research Network (TARN), Health Sciences Research Group, School of Community Based Medicine, Manchester Academic Health Sciences Centre, University of Manchester, Salford Royal Hospital, Stott Lane, M6 8HD, Salford, UK aut NATIONALLICENCE 773 0- European Spine Journal Springer-Verlag 20/12(2011-12-01), 2174-2180 0940-6719 20:12<2174 2011 20 586 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer