• ChanDavid Yuen ChungDYCDivision of Neurosurgery, Department of Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, New Territories, Hong Kong SAR. Electronic address: davidchan@surgery.cuhk.edu.hk., Orson Yuzhong He, Wai Sang Poon, NgStephanie Chi PingSCPDivision of Neurosurgery, Department of Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, New Territories, Hong Kong SAR., Janice Hiu Hung Yeung, Kevin Kei Ching Hung, Wai Kit Mak, Danny Tat Ming Chan, Nai Kwong Cheung, James F Griffith, Colin A Graham, and WongGeorge Kwok ChuGKCDivision of Neurosurgery, Department of Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, New Territories, Hong Kong SAR..
• Division of Neurosurgery, Department of Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, New Territories, Hong Kong SAR. Electronic address: davidchan@surgery.cuhk.edu.hk.
• World Neurosurg. 2022 Oct 1; 166: e832e840e832-e840.

ObjectiveThis study aims to identify independent factors associated with cervical spinal injuries in head-injured patients. The extent of injuries to other body parts was assessed by the Abbreviated Injury Scale (AIS) and was included in the analysis.MethodsConsecutive head-injured patients admitted via the emergency department from January 1, 2014 to December 31, 2016 were retrospectively reviewed. The inclusion criteria were head-injured patients with an Abbreviated Injury Scale (AIS) score ≥2 (i.e., head injuries with intracranial hematoma or skull fracture). Patients with minor head injuries with only scalp abrasions or superficial lacerations without significant intracranial injuries (i.e., head injury AIS score = 1) were excluded. The primary outcome was to identify independent predictors associated with cervical spinal injuries in these head-injured patients. Univariate and multivariable analyses were conducted.ResultsA total of 1105 patients were identified. Of these patients, 11.2% (n = 124) had cervical spinal injuries. Univariate and multivariable analyses identified male gender (P = 0.006), the presence of thoracic injury (including rib fracture, hemothorax, or pneumothorax) (P = 0.010), and hypotension with systolic blood pressure <90 mm Hg on admission (P = 0.009) as independent predictors for cervical spinal injury in head-injured patients.ConclusionsThis study showed that about 1 in 10 patients with significant head injury had cervical spine injury, usually associated with fracture or dislocation. Male gender, the presence of thoracic injury, and hypotension on admission were independent risk factors associated with cervical spinal injuries.Copyright © 2022 Elsevier Inc. All rights reserved.

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