Sex-related discrepancies in the epidemiology, injury characteristics and outcomes after acute spine trauma: A retrospective cohort study

The Journal of Spinal Cord Medicine, 2019 · DOI: 10.1080/10790268.2019.1607055 · Published: January 1, 2019

Simple Explanation

This study investigates how sex influences injury characteristics and outcomes after acute spine trauma (AST). It compares females and males regarding the epidemiology, injury characteristics, and clinical outcomes of AST. The study found that females with AST often have more pre-existing health issues, are more likely to experience trauma in the thoraco-lumbar region, and tend to have less severe neurological impairment. Motor vehicle accidents were also more common in females. Despite these differences, the length of stay in the acute spine center, in-hospital survival, the need for mechanical ventilation, and tracheostomy were similar for both sexes after AST.

Study Duration

12 years

Participants

504 individuals with acute spine trauma (161 females, 343 males)

Evidence Level

Retrospective cohort study

Key Findings

1
Females with AST presented with a greater number of pre-existing co-morbidities compared to males.
2
Thoraco-lumbar trauma was more frequent in females, while cervical trauma was more common in males.
3
Females and males had similar lengths of stay in the acute spine center, comparable in-hospital survival, need for mechanical ventilation, and tracheostomy after AST.

Research Summary

This study examined the influence of sex on the epidemiology, injury characteristics, and clinical outcomes of acute spine trauma (AST). The study found that females had a greater number of pre-existing co-morbidities and a higher frequency of thoraco-lumbar trauma, but less severe neurological impairment compared to males. Despite these differences, there were no significant sex-related differences in the length of stay in the acute spine trauma center and in-hospital survival after AST.

Practical Implications

Clinical Guidelines

Current acute spine trauma care guidelines do not need to account for sex as a key determinant of patient outcomes.

Management Strategies

While neurological impairment might be less severe in females, a greater number of co-morbidities (assessed by CIRS) can pose management challenges.

Further Research

Further investigation is needed to determine the best measures of pre-existing medical co-morbidities when evaluating outcomes after AST, especially in rehabilitation centers.

Study Limitations

1
Selection bias may occur in any retrospective cohort study.
2
The Spinal Cord Database includes only data with regards to admissions at an acute spine trauma center from January/1996 to December/2007.
3
Data on other potential confounding factors such as secondary complications of AST were not available for further adjusted analyses.

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