Polytrauma patients with severe cervical spine injuries are different than with severe TBI despite similar AIS scores

Scientific Reports, 2022 · DOI: 10.1038/s41598-022-25809-8 · Published: December 15, 2022

Simple Explanation

This study investigates the differences between severely injured polytrauma patients with traumatic cervical spine injuries (TCSI) and those with traumatic brain injuries (TBI), despite similar Abbreviated Injury Scale (AIS) scores. The study found that TCSI patients often had lower systolic blood pressure upon arrival at the emergency department and stayed longer in the ICU compared to TBI patients. The causes of death also differed, with TCSI patients more likely to die from high cervical spine injuries or respiratory insufficiency, while TBI patients primarily died from brain injuries.

Study Duration

From November 2013–November 2021

Participants

284 polytrauma patients

Evidence Level

Not specified

Key Findings

1
The incidence of severe TCSI in polytrauma patients was lower than that of severe TBI.
2
TCSI patients had lower systolic blood pressure in the ED compared to TBI patients.
3
Cause of death differed between the groups, with TCSI patients dying primarily from spinal cord injuries or respiratory insufficiency, and TBI patients dying from brain injuries.

Research Summary

This study compared polytrauma patients with severe traumatic cervical spine injuries (TCSI) to those with severe traumatic brain injuries (TBI), revealing differences in epidemiology, demographics, and outcomes. TCSI patients had lower systolic blood pressure in the ED and longer ICU stays, and differing causes of death compared to TBI patients, suggesting that AIShead based on TCSI is a distinct entity from AIShead based on TBI. The study concludes that injuries to the cervical spine should be distinguished from TBI in morbidity and mortality analyses to avoid data misinterpretation.

Practical Implications

Clinical Differentiation

Clinicians should recognize TCSI as a distinct entity from TBI in polytrauma patients.

Targeted Treatment

Treatment strategies should be tailored to the specific injury type (TCSI vs. TBI) to address the differing physiological and mortality risks.

Data Analysis

Morbidity and mortality analyses should differentiate between cervical spine injuries and TBI to avoid misinterpretation of data.

Study Limitations

1
Retrospective analysis of a single center prospective cohort study with relatively low numbers.
2
Treating clinicians were also the researchers.
3
No details on comorbidities were collected nor any post discharge data on polytrauma patients with associated TBI.

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