Epidemiology of Cervical Spine Lesions in the Multiply Injured Patient – Recent Data of the Traumaregister DGU®
Matthias Weuster, Tim Klueter, Christina Hofgaertner, Peter Beherndt, Leif Menzdrof, Rolf Lefering, Stefanie Fitschen-Oestern, Andreas Seekamp, Sebastian Lippross and Trauma Register DGU
World Journal of Trauma and Critical Care Medicine 2016, 4:3
A cervical spine lesion (CSL) is
common among polytrauma patients. Injuries may be life threatening. The
clinical impact of CSL in multiple injured patients is the focus of this study.
A retrospective investigation on a
total of 62,903 patients of the Trauma Register DGU® from
2009 and 2014 was performed. Preclinical and clinical data were analyzed.
The cohort depicted the typical severity
in polytrauma (mean age 51 ±21;
mean ISS of 22 ± 12). 1,321 patients sustained a CSL with an AIS 4-6 including
complete spinal cord syndrome. The number of male patients was more than
twice as high as of female patients. Leading causes for CSL were car
accidents, falls from <3m height and falls from >3m height. 12,023 patients
were unconscious (GCS ≤8).
The majority had a CSL of AIS <2. 406 unconscious patients suffered from a
CSL with an AIS 4-6. Cardiopulmonary resuscitation (CPR) was performed in 2,000
patients in the preclinical setting and 1,003 patients received CPR in the
resuscitation bay. Severe CSL (AIS 4-6) had a significantly lower blood
pressure (102mmHg ± 46) and a significantly
lower heart rate (74/min ± 34) than patients with less severe CSLs
(AIS <2). Hospitalization
was extended with the severity of CSL. Early mortality was high. More than half
of the patients with CSLs (AIS 2-6) died within the first 24 hours. 404
patients were transferred to a rehabilitation facility.
spine lesions imply a peculiar element among polytrauma patients. Early
mortality correlates with the severity of CSL. Rehabilitation facilities are
mainly the end point.
Cervical spine lesion, spinal cord
injury, Glasgow Coma Scale, multiple trauma, TraumaRegister DGU®