Abstract
Introduction: Little is known about the epidemiology of spinal injuries in large major trauma populations. The aim of this study, therefore, is to describe mechanisms of injury, patient and injury characteristics and outcomes following spinal injuries in major trauma patients.
Methods: Data was extracted from the State Trauma Registry for Victoria (population 4.6 million) on all patients registered between 1 July 2001 and 31 June 2003 with spinal injuries and an Injury Severity Score (ISS) > 15. Injuries were defined using Abbreviated Injury Score (AIS) codes. Major trauma patients with spinal injuries were compared with those without spinal injuries with respect to age, gender, ISS scores, mechanism of injury, number and site of spinal and associated injuries, acute length of stay and discharge destination.
Results: 2194 major trauma patients were identified, of which 548 (25%) had spinal injuries. Spinal injuries occurred in 412 males (75%) and 136 females (25%), with a median age of 36 years (range 2–94 years). There was no difference in age or gender compared with patients with no spinal injury. 316 patients (58%) had multiple spinal injuries. 22% of patients with spinal injuries had associated spinal cord injuries. Most spinal fractures occurred and were more likely to occur as the result of motor vehicle (46%) or motorcycle (16%) crashes or falls from heights greater than 1 metre (15%).
The median ISS score was 24 (range 16–75) and not significantly different from patients with no spinal injury. The median number of associated injuries was 5 (range 0–23) and patients with spinal injuries were more likely to have associated thoracic, abdominal and extremity injuries and less likely to have associated head injuries than patients with no spinal injury. Patients with spinal injuries were more likely to be discharged to rehabilitation or convalescent hospitals and less likely to die than patients with no spinal injury.
Discussion: Spinal injuries are common and often multiple in major trauma patients and are associated with a greater need for rehabilitation. Further studies are required to determine the impact of spinal injuries on the functional outcomes of major trauma patients.
The abstracts were prepared by I. B. McPhee. Correspondence should be addressed to the Spine Society of Australia Secretariat, The Adelaide Centre for Spinal Research, Institute of Medical and Veterinary Science, PO Box 14, Rundle Mall, Adelaide SA 5000, Australia.
