261. Outcomes in patients with vertebral injury after cervical spine trauma

Abstract

<h3>BACKGROUND CONTEXT</h3> Vertebral artery injury (VAI) occurs in almost 1% of all blunt trauma hospital admissions. No large study has been conducted investigating outcomes of VAI in blunt cervical trauma. <h3>PURPOSE</h3> The objectives of this study were to evaluate 1-year outcomes in patients with blunt cervical spine trauma with vertebral artery injuries. <h3>STUDY DESIGN/SETTING</h3> Data from the National Trauma Data Bank (NTDB) in 2016 was analyzed. <h3>PATIENT SAMPLE</h3> Adult patients with cervical vertebral, ligamentous, or neurological trauma were included in the study. Patients who died within 3 days of admission were excluded. <h3>OUTCOME MEASURES</h3> Response variables collected included development of adverse events (DVT/PE, myocardial infarction (MI), stroke, hemorrhage, or neurological deficit) length of stay (LOS), intensive care unit (ICU) LOS, and unplanned ICU admission or surgical procedure. <h3>METHODS</h3> Demographic information (age, sex, race), injury specific information (mechanism, severity), patient health information, and a variable indicating the presence of vertebral artery injury were collected as explanatory variables. Multivariable regression was used to calculate the risk-adjusted effect of vertebral artery injury on the presence of adverse events and unplanned events as well as its relationship with LOS and ICU LOS. <h3>RESULTS</h3> A total of 64,662 patients with cervical trauma were reviewed, of which 2,310 had VAI. Of the patients with VAI, the 82 (3.6%) patients had a MI, 80 (3.5%) had a PE/DVT, 76 (3.3%) had a stroke, 36 (1.6%) had neurologic injury, and 94 (4.1%) had an unplanned operative procedure or ICU admission. After risk-adjustment, VAI was associated with an increased LOS and ICU LOS (p<0.001), as well as an increased risk of MI, PE/DVT, stroke, and neurologic injury (p<0.001). <h3>CONCLUSIONS</h3> Vertebral artery injury in cervical trauma leads to increase chance of adverse events and length of stay in the ICU and in the hospital. Trauma providers should be aware of these increased risks when treating patients with VAI in cervical trauma. <h3>FDA DEVICE/DRUG STATUS</h3> This abstract does not discuss or include any applicable devices or drugs.