P155. Mortality and cause of death in patients with traumatic spinal injury: a propensity matched cohort study among 2,893 patients with major trauma

Abstract

<h3>BACKGROUND CONTEXT</h3> Major trauma is defined as significant injury or injuries that have potential to be life-threatening or life-changing, which is quantitatively identified as an Injury Severity Score (ISS) of > 15. The ISS is a widely used anatomical scoring system because of its high correlation with mortality. But since spinal injuries are not independently reflected in the ISS calculation, the effect of spinal injury on mortality in patients with major trauma has not been fully explained. <h3>PURPOSE</h3> The purpose of this study is to investigate the effect of spinal injury on mortality and outcome in patients with major trauma. <h3>STUDY DESIGN/SETTING</h3> A propensity-matched cohort study. <h3>PATIENT SAMPLE</h3> We evaluated patients with major trauma who visited a Level 1 trauma center between January 2016 and December 2020. <h3>OUTCOME MEASURES</h3> Mortality rate. <h3>METHODS</h3> We compared demographics, injury mechanisms and accompanying injuries between the groups with and without spinal injuries. Factors affecting mortality were controlled through propensity score matching, and the effect of spinal injury was analyzed. <h3>RESULTS</h3> Of the 2,893 patients analyzed, 781 (27.0%) had spinal injury and 2,112 (73.0%) had no spinal injury. There were significant differences in the gender, ISS, injury mechanism, revised trauma score (RTS) and type of accompanying injuries. With the use of propensity-score matching, 781 patients were matched. The mortality rate was significantly lower in the spinal injury group (4.0% vs 7.9%), and conversely, the length of stay in the intensive care unit was longer (8.8 ± 17.4 days vs 7.2 ± 11.7 days). The main cause of death in the spinal injury group was multiple organ failure (MOF), and the cause of death in the matching cohort was central nerve system (CNS) damage. <h3>CONCLUSIONS</h3> The group with spinal injury had a significantly lower mortality rate than the group without spinal injury. Therefore, it is thought that spinal injuries in severe trauma patients act as shock absorbers for internal organs. <h3>FDA DEVICE/DRUG STATUS</h3> This abstract does not discuss or include any applicable devices or drugs.