Z Orthop Unfall 2021; 159(04): 421-429
DOI: 10.1055/a-1121-7989
Original Article/Originalarbeit

Spinal Injury Without Neurological Symptoms in Severely Injured Patients: Impact on the Length of Stay?

Article in several languages: English | deutsch
Ulrike Fochtmann
1   Klinik für Unfallchirurgie und Orthopädie, Alfried Krupp Krankenhaus Steele, Essen
Pascal Jungbluth
2   Klinik für Orthopädie und Unfallchirurgie, Universitätsklinikum Düsseldorf
Werner Zimmermann
3   Klinik für Orthopädie und Unfallchirurgie, Alfried Krupp Krankenhaus Rüttenscheid, Essen
Rolf Lefering
4   Institut für Forschung in der Operativen Medizin (IFOM), Universität Witten/Herdecke, IFOM Köln
Sven Lendemans
3   Klinik für Orthopädie und Unfallchirurgie, Alfried Krupp Krankenhaus Rüttenscheid, Essen
5   Universität Duisburg-Essen
Bjoern Hussmann
3   Klinik für Orthopädie und Unfallchirurgie, Alfried Krupp Krankenhaus Rüttenscheid, Essen
› Author Affiliations


Background The impact of spinal injuries on clinical outcome in most severely injured patients is currently being controversially discussed. At the same time, most of the studies examine patients with post-traumatic neurological disorders. The aim of this study was therefore to analyse severely injured patients with spinal injuries but without neurological symptoms with regard to their clinical outcome. Here the focus was then on the question, whether spinal injury is an independent risk factor increasing length of stay in the intensive care unit and in the hospital in total.

Material and Methods Data of the TraumaRegister DGU® were retrospectively analysed. Inclusion criteria were: Injury Severity Score ≥ 16, primary admission, age ≥ 16 years, time interval 2009 – 2016, and a full data set on length of stay in the hospital and the intensive care unit, respectively. Following a univariate analysis in the first step, independent risk factors for the length of stay in the intensive care unit and in the hospital in total were investigated using a multivariate regression analysis.

Results 98,240 patients met the inclusion criteria. In this population, patients with Abbreviated Injury Scale (AIS) 2 and 3 spinal injuries were significantly younger (up to 60 years), and injuries were significantly more commonly caused by falls from a great height and traffic accidents (age ≤ 60 years: AISSpine 0: 58.4%, AISSpine 3: 65%; p < 0.001). Multivariate analysis showed that spinal injury without neurological symptoms is an independent risk factor for increased length of stay in the intensive care unit (odds ratio: + 1.1 d) and in the hospital in total (AIS 3 odds ratio: + 3.4 d).

Conclusion It has been shown for the first time that spinal injury without initial neurological symptoms has a negative impact on the length of stay of most severely injured patients in the intensive care unit and in the hospital in total and thus represents an independent risk factor in this group of patients.

Publication History

Article published online:
11 May 2020

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