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Concomitant spine trauma in patients with traumatic brain injury: Patient characteristics and outcomes
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2022 (English)In: Frontiers in Neurology, E-ISSN 1664-2295, Vol. 13, article id 861688Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE: Spine injury is highly prevalent in patients with poly-trauma, but data on the co-occurrence of spine trauma in patients with traumatic brain injury (TBI) are scarce. In this study, we used the Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) database to assess the prevalence, characteristics, and outcomes of patients with TBI and a concurrent traumatic spinal injury (TSI).

METHODS: Data from the European multi-center CENTER-TBI study were analyzed. Adult patients with TBI (≥18 years) presenting with a concomitant, isolated TSI of at least serious severity (Abbreviated Injury Scale; AIS ≥3) were included. For outcome analysis, comparison groups of TBI patients with TSI and systemic injuries (non-isolated TSI) and without TSI were created using propensity score matching. Rates of mortality, unfavorable outcomes (Glasgow Outcome Scale Extended; GOSe < 5), and full recovery (GOSe 7-8) of all patients and separately for patients with only mild TBI (mTBI) were compared between groups at 6-month follow-up.

RESULTS: A total of 164 (4%) of the 4,254 CENTER-TBI core study patients suffered from a concomitant isolated TSI. The median age was 53 [interquartile range (IQR): 37-66] years and 71% of patients were men. mTBI was documented in 62% of cases, followed by severe TBI (26%), and spine injuries were mostly cervical (63%) or thoracic (31%). Surgical spine stabilization was performed in 19% of cases and 57% of patients were admitted to the ICU. Mortality at 6 months was 11% and only 36% of patients regained full recovery. There were no significant differences in the 6-month rates of mortality, unfavorable outcomes, or full recovery between TBI patients with and without concomitant isolated TSI. However, concomitant non-isolated TSI was associated with an unfavorable outcome and a higher mortality. In patients with mTBI, a negative association with full recovery could be observed for both concomitant isolated and non-isolated TSI.

CONCLUSION: Rates of mortality, unfavorable outcomes, and full recovery in TBI patients with and without concomitant, isolated TSIs were comparable after 6 months. However, in patients with mTBI, concomitant TSI was a negative predictor for a full recovery. These findings might indicate that patients with moderate to severe TBI do not necessarily exhibit worse outcomes when having a concomitant TSI, whereas patients with mTBI might be more affected.

Place, publisher, year, edition, pages
Frontiers Media S.A., 2022. Vol. 13, article id 861688
Keywords [en]
CENTER-TBI, outcome, spine trauma, traumatic brain injury, traumatic spine injury
National Category
Anesthesiology and Intensive Care
Identifiers
URN: urn:nbn:se:umu:diva-221580DOI: 10.3389/fneur.2022.861688ISI: 000848471100001PubMedID: 36062004Scopus ID: 2-s2.0-85138012888OAI: oai:DiVA.org:umu-221580DiVA, id: diva2:1841008
Funder
EU, FP7, Seventh Framework Programme, 602150Available from: 2024-02-27 Created: 2024-02-27 Last updated: 2024-02-28Bibliographically approved

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Brorsson, CamillaKoskinen, Lars-Owe D.Sundström, Nina

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Department of Surgical and Perioperative SciencesNeurosciencesDepartment of Radiation Sciences
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CiteExportLink to record
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