Anatomical injury patterns, demographics and outcomes data for blunt and penetrating neck injuries on the Trauma Audit and Research Network database

Abstract

Introduction Penetrating neck trauma is a relatively rare though potentially devastating mode of injury. To date, there has been no analysis on this subject using the Trauma Audit and Research Network (TARN) dataset for the population of England, Wales and Northern Island. Methods This was a retrospective observational study using the TARN dataset to identify all adult patients (≥16 years) presenting with neck trauma between January 2012 and March 2019. Results A total of 2,395 patients met the inclusion criteria for this study: 1,584 with blunt injuries to the neck (374 isolated injuries) and 811 with penetrating neck injuries (412 isolated injuries). The median age of the study population was 44.2 years and 73% were male. The unadjusted mortality rate was 18.2%. Seventy-nine per cent of patients with penetrating injuries required surgical exploration. The odds ratios (ORs) of injury to the trachea, pharynx/retropharynx, jugular vein and larynx were all significantly increased with penetrating injuries to the neck. There was significantly increased mortality for those patients suffering hyoid bone injury (OR: 3.07, 95% confidence interval [CI]: 2.10–4.49), carotid artery injury (OR: 1.81, 95% CI: 1.41–2.32) and laryngeal injury (OR: 1.25, 95% CI: 0.95–1.65). Conclusions Our data highlight the potentially devastating consequence of neck injury with associated injury patterns. Patients suffering penetrating neck trauma have complex care requirements needing appropriate specialty input.