AI Article Synopsis
- The study assesses the incidence of cervical spine injuries (CSI) in patients with blunt head injuries (HI) in Scotland, finding that 5.3% had associated CSIs.
- Patients with a Glasgow Coma Score (GCS) of 3 were significantly more likely (12.5%) to have a CSI compared to those with a GCS of 4 or higher (4.4%).
- Excluding GCS 3 patients, there was no relationship found between lower GCS scores and increased incidence of CSI, indicating that the GCS isn't a reliable predictor for risks of CSI in these cases.
Article Abstract
Background: In the Accident and Emergency Department, the management of patients who have sustained head injuries (HI) is often made more complicated by the suspicion of a cervical spine injury (CSI). This study aimed to evaluate the incidence of CSI in patients sustaining blunt head injuries in a Scottish population.
Methods: Retrospective analysis of prospectively collected data for a 5-year period from the Scottish Trauma Audit Group (STAG) database. Logistic regression and other comparisons were used to investigate the relationship between Glasgow coma score/scale (GCS) and the incidence of CSI.
Results: A total of 5154 patients met the criteria for the study and 273 of the HI patients had associated CSI giving an overall incidence of 5.3%. Patients presenting with GCS of 3 were almost three times more likely to have a CSI compared to patients with an initial GCS of 4 or more (12.5% versus 4.4%, chi(2)=62.9, d.f.=1, P<0.001). When patients with GCS of 3 were excluded, there was no evidence of an increase in the incidence of CSI with a lower GCS (logistic regression chi(2)=0.09, d.f.=1, P=0.75).
Conclusion: The risk of CSI in patients with blunt head trauma and an admission GCS of > or =4 does not decrease as GCS increases. Patients with blunt head injuries who present with a GCS of 3 are much more likely to have a concomitant CSI. The overall incidence of 5.3% compares with published series from other countries.
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| http://dx.doi.org/10.1016/s0020-1383(02)00260-7 | DOI Listing |
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