• J S Hebert and R S Burnham.
• Physical Medicine and Rehabilitation Department, University of Alberta, Glenrose Rehabilitation Hospital, Edmonton. jhebert@gpu.srv.ualberta.ca
• Spine. 2000 Jan 1;25(1):55-60.

Study DesignA mixed cross-sectional survey and cohort study using a prospectively gathered database of persons with traumatic spine injury.ObjectivesTo identify demographic and injury mechanism factors that predict greater injury severity, and to determine the effect of injury severity on outcomes in traumatic spine fracture.Summary Of Background DataTraumatic spine fracture outcome studies have focused on defining type and level of vertebral fracture without considering the severity of associated injuries. In the trauma population, greater injury severity has been shown to be related to worse outcome. No studies have been reported on the effect of injury severity on outcome in the traumatic spine fracture population.MethodsProspectively collected data on 830 persons with traumatic spine injury who were admitted to a trauma hospital were reviewed. Patient demographics; injury mechanism; hospital events; and disability, employment, and pain status at discharge, 1 year, and 2 years after injury were recorded. Associations between these factors and trauma severity (Injury Severity Score) were explored using Pearson's correlation and analysis of variance.ResultsTrauma was more severe in patients who had been married previously, who were involved in a motor vehicle accident, were ejected from the vehicle, had loss of consciousness, had higher-level and multiple complicated vertebral fractures, or had neurologic deficit. Those more severely injured had longer lengths of stay, more surgery, more complications, higher mortality, more disability, and less return to work.ConclusionsPersons with traumatic spine injury and polytrauma have poorer short- and long-term outcomes. This high-risk group may require aggressive interventions, more hospital resources, and close follow-up observation after discharge from hospital to optimize outcome.

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