Impact of spinal injury on mortality in patients with major trauma: A propensity-matched cohort study
- 주제(키워드) Major trauma , spinal injury , injury severity score , shock absorber
- 주제(DDC) 610
- 발행기관 아주대학교 일반대학원
- 지도교수 이두형
- 발행년도 2024
- 학위수여년월 2024. 8
- 학위명 박사
- 학과 및 전공 일반대학원 의학과
- 실제URI http://www.dcollection.net/handler/ajou/000000034162
- 본문언어 한국어
- 저작권 아주대학교 논문은 저작권에 의해 보호받습니다.
초록/요약
Major trauma is defined as a significant injury or injury that has the potential to be life-threatening and is quantitatively identified as an injury severity score (ISS) > 15. Spinal injuries are common in patients with major trauma; however, because spinal injury is not independently included in the ISS calculation, the impact of spinal injury on mortality in patients with major trauma has not been fully elucidated. This study aims to provide reliable epidemiologic data on major trauma with spine injury. From January 1, 2016, to December 31, 2020, retrospective analysis was conducted on 2,893 major trauma adult patients admitted to a level 1 trauma center. There were 781 patients in the spinal injury group and 2,112 patients in the group without spinal injury. After matching the two groups 1:1, we compared injury mechanism, mortality, cause of death, intensive care unit length of stay (ICU LOS), and duration of ventilator use between spinal injury group and matched cohorts. Falls and traffic accidents were the most common injury mechanisms in the spinal injury group and the matched cohort, respectively. The mortality was significantly lower in the spinal injury group compared with the matched cohort (4.0% vs. 7.9%, P = 0.001), and the ICU LOS was longer than the matched cohort (8.8 ± 17.4 days vs. 7.2 ± 11.7 days, P = 0.028). In the spinal injury group, multiple organ failure was the most common cause of death (41.9%), while that in the matched cohort was central nervous system damage (61.3%). In patients with major trauma, spinal injury may act as a shock absorber for internal organs, which is thought to lower the mortality rate.
more목차
I . Introduction 1
II . Materials and Methods 3
A. Study Design and Population 3
B. Propensity Score Matching and Outcomes 6
C. Statistical Analysis 7
III . Results 8
A. Baseline Characteristics 8
B. Comparison of Mortality and Cause of death between Propensity-Score-Matched groups 9
C. Kyphotic Progression in Survivors of the Spinal injury group 13
IV. Discussion 15
A. Limitations of ISS 15
B. Mechanisms of Injury 17
C. Mortality 19
D. Kyphotic Progression 21
E. Stregths and Limitations 22
V. Conclusion 24
References 25
