Citation

Galganski LA, Cox JA, Greenhalgh DG, Sen S, Romanowski KS, Palmieri TL. J. Burn Care Res. 2019; 40(3): 263-268.

Affiliation

Department of Surgery, Division of Burn Surgery, University of California Davis; Shriners Hospital for Children Northern California, Sacramento, CA.

Copyright

(Copyright © 2019, American Burn Association, Publisher Lippincott Williams and Wilkins)

DOI

10.1093/jbcr/irz022

PMID

30801641

Abstract

BACKGROUND: Cervical spine injuries (CI) carry significant morbidity and mortality; hence, cervical spine immobilization is used liberally in trauma patients, including burns. The incidence, predictors and outcomes of CI in burn patients are unknown. STUDY DESIGN: A retrospective cohort from the National Trauma Data Bank between 2007-2012 included all burned patients with and without CI. Predictors of CI were identified by logistic regression. Outcomes with and without CI were compared with Wilcoxon rank sum test.

RESULTS: 94,964 patients were identified with burn injuries. The incidence of CI was 0.79% (n=745). Mechanism of injury, age, and injury severity score (ISS) were significant predictors of CI. Odds of CI was 109.4 (95% CI 61.2-195.3, p <0.0001) for motor vehicle injury, 87.8 (95% CI 47.0-164.0, p<0.0001) for falls, 1.2 (95% CI 0.6-2.3, p=0.66) for fire/flame, and 2.4 (95% CI 1.0-5.5, p<0.0001) for explosion compared to reference of hot object/substance. For every year increase in age, there was a 1.02 higher odds of CI (95% CI 1.01-1.02, p<0.0001). For each point increase in ISS, there was a 1.05 higher odds of CI (95% CI 1.04-1.05, p<0.0001). Patients with CI had higher mortality (10.3% vs 2.9% p<0.0001), longer total length of stay (12.0 vs 2.0 days, p<0.0001), intensive care unit length of stay (4.0 vs 0.0 days, p<0.001), and ventilator days (1.0 vs 0.0 days, p<0.0001).

CONCLUSIONS: The incidence of CI in burn patients is low, especially when due to fire, flame or scalds, however CI is associated with higher mortality and worse outcomes.

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Language: en

Keywords

Burns; cervical spine injury; mechanism; nervous system; trauma