Definitive Establishment of Airway Control is Critical for Optimal Outcome in Lower Cervical Spinal Cord Injury

• DOI: 10.1097/ta.0b013e31818d07e4
• Publication Date: 2008-12-03T08:43:37Z
• Authors: Victor J. Hassid; Miren A. Schinco; Joseph J. Tepas; Margaret M. Griffen; Terri L. Murphy; Eric R. Frykberg; Andrew J. Kerwin
• Keywords: Adult; Male; Adolescent; Apnea; Incidence; Resuscitation; Middle Aged; 3. Good health; Survival Rate; Intensive Care Units; 03 medical and health sciences; Cross-Sectional Studies; Injury Severity Score; 0302 clinical medicine; Cervical Vertebrae; Intubation, Intratracheal; Humans; Spinal Fractures; Female; Child; Respiratory Insufficiency; Spinal Cord Injuries; Retrospective Studies

Background: Respiratory complications can undermine outcome from low cervical spinal cord injury (SCI) (C5-T1). Most devastating of these is catastrophic loss airway control. This study sought to determine the incidence and effect (CLA) define need for elective intubation with subsequent tracheostomy prevent potentially fatal outcomes. Methods: A database 54,838 consecutive patients treated in a level I trauma center between January 1988 December 2004 was queried identify SCI, without traumatic brain injury. Patients were then stratified into complete or incomplete SCI groups, based on clinical assessment their SCI. Mortality, age, severity, intubation, analyzed each group using Fisher's exact test Student's t test, as appropriate, accepting p < 0.05 significant. Results: One hundred eighty-six met inclusion criteria. The majority injuries (58%). Overall, 127 (68%) required 88 (69%) tracheostomy, 27 died (15% population). Between there significant differences age Injury Severity Score, however, within no either. Eleven CSCI not intubated; four whom at family request. Six remaining seven encountered loss. patient discharged rehabilitation. less frequently (38%); 50% those intractable pulmonary failure. Conclusions: These data indicate that regardless severity immediate, thorough evaluation respiratory failure necessary. Early mandatory patients. For evidence should prompt immediate intervention, half will require tracheostomy.