•  
  •  
 

Corresponding Author

Anna O’Hanlon, MD.

Subject Area

Lumbosacral spine, Non-operative therapy, Thoracic spine, Trauma

Article Type

Original Study

Abstract

Background: Spinal injuries are common and are associated with complications either directly related to the spinal injury itself, including autonomic or cord related events, or indirectly related medical complications. These complications are a frequent cause of morbidity and mortality and lead to an increase in the rates of hospitalisation, higher care costs, and decreased quality of life.

Purpose: Our primary outcomes were the impact of management on in-patient outcomes of medical complications, length of hospital stay, physical function on day three and discharge destination. Our secondary aim was to assess the impact of injury characteristics, ASIA score and level of injury (above lumbar and lumbosacral spine) on these outcomes.

Study Design: We conducted a retrospective observational study.

Patients and Methods: We included 129 patients who were admitted, to a state tertiary center over a 6-month period. Binary logistic and Cox proportional hazards regression models were used to assess the relationships between injury characteristics and management on inpatient outcomes. The models were adjusted for age, sex, baseline functional status and Charlson’s Comorbidity Index.

Results: The mean age of the study sample was 48.6 (SD 23.4) years and 61.3% were males. The majority of the patients were ASIA E (92.2%) and 26 patients (20.2%) were treated surgically. Those who had a surgical approach were more likely to have inpatient complications (Odds ratio (OR) 11.3, 95% CI 3.26-38.8), be discharged to care facilities (OR 12.2, 95% CI 1.71-87.3) , are less likely to discharge early (Hazard ration(HR) 0.15, 95% CI 0.09-0.26) and not be independent on day 3 post admission (OR 51.9, 95% CI 7.21-374.0). These outcomes were also evident in those who were ASIA E compared to ASIA A-D. Whether the injury was above lumbar or lumbosacral spine was not associated with any of the outcomes measured.

Conclusion: Severity of the spinal injury and surgical management are strongly associated with unfavorable in-patient outcomes irrespective of basic demographic variabilities and therefore, are universally relevant.

Keywords

Spinal injuries, spinal fracture, complications, surgery, immobilisation, length of stay, conservative treatment, orthopaedic, cohort study, level 3 evidence

Download

Share

COinS