Pedestrians Injured by Automobiles: Risk Factors for Cervical Spine Injuries

Hakan Yanar, Demetrios Demetriades, Pantelis Hatzizacharia, Shirley Nomoto, Ali Salim, Kenji Inaba, Peter M Rhee, Linda S. Chan

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

Background: Diagnosis of cervical spine injuries (CSI) in multitrauma patients, especially in the presence of head trauma, can be difficult. Identification of risk factors associated with CSI can help avoid missed or delayed diagnosis. Methods: Trauma registry study of pedestrian injuries caused by being hit by an automobile. Data abstracted for each patient included age, gender, Glasgow Coma Score on admission, Injury Severity Score, Abbreviated Injury Scale (AIS) for each body area, level of cervical spine injuries, and associated injuries. The incidence of spine injuries was derived for 4 age groups (14 years and younger, 15 to 55 years, 56 to 65 years, and older than 65 years). Logistic regression analysis was performed to identify risk factors associated with CSI. Results: There were 8,401 pedestrian injuries caused by automobiles, and 178 patients (2.1%) had CSI. Incidence of CSI increased with age (0.3% in the age group 14 years and younger, 2.2% in the group 15 to 55 years, 3.7% in the group 56 to 65 years, and 4.4% in the group older than 65 years). Using the youngest age group (14 years and younger) as reference, relative risk of CSI in the other groups was 7.0, 12.1, and 14.2, respectively (p < 0.0001). Patients with severe head trauma (AIS > 3) were significantly more likely to have CSI than patients with less severe head injuries (AIS ≤ 3) (1.3% versus 9.0%, p < 0.0001). In the group of 5,040 injuries with no head trauma, there was not even a single case of CSI. Stepwise logistic regression analysis identified age, severe head injury (AIS > 3), severe chest trauma (AIS > 3), pelvic fracture, and femur fracture as independent risk factors for CSI. Conclusions: Incidence of CSI after injuries to pedestrians hit by automobiles increases with age and severity of head trauma. Age, severe head trauma, severe chest trauma, pelvic fracture, and femur fractures are independent predictors of CSI.

Original languageEnglish (US)
Pages (from-to)794-799
Number of pages6
JournalJournal of the American College of Surgeons
Volume205
Issue number6
DOIs
StatePublished - Dec 2007
Externally publishedYes

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Automobiles
Spine
Wounds and Injuries
Abbreviated Injury Scale
Craniocerebral Trauma
Pedestrians
Age Groups
Femur
Incidence
Thorax
Injury Severity Score

ASJC Scopus subject areas

  • Surgery

Cite this

Yanar, H., Demetriades, D., Hatzizacharia, P., Nomoto, S., Salim, A., Inaba, K., ... Chan, L. S. (2007). Pedestrians Injured by Automobiles: Risk Factors for Cervical Spine Injuries. Journal of the American College of Surgeons, 205(6), 794-799. https://doi.org/10.1016/j.jamcollsurg.2007.06.280

Pedestrians Injured by Automobiles : Risk Factors for Cervical Spine Injuries. / Yanar, Hakan; Demetriades, Demetrios; Hatzizacharia, Pantelis; Nomoto, Shirley; Salim, Ali; Inaba, Kenji; Rhee, Peter M; Chan, Linda S.

In: Journal of the American College of Surgeons, Vol. 205, No. 6, 12.2007, p. 794-799.

Research output: Contribution to journalArticle

Yanar, H, Demetriades, D, Hatzizacharia, P, Nomoto, S, Salim, A, Inaba, K, Rhee, PM & Chan, LS 2007, 'Pedestrians Injured by Automobiles: Risk Factors for Cervical Spine Injuries', Journal of the American College of Surgeons, vol. 205, no. 6, pp. 794-799. https://doi.org/10.1016/j.jamcollsurg.2007.06.280
Yanar, Hakan ; Demetriades, Demetrios ; Hatzizacharia, Pantelis ; Nomoto, Shirley ; Salim, Ali ; Inaba, Kenji ; Rhee, Peter M ; Chan, Linda S. / Pedestrians Injured by Automobiles : Risk Factors for Cervical Spine Injuries. In: Journal of the American College of Surgeons. 2007 ; Vol. 205, No. 6. pp. 794-799.
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abstract = "Background: Diagnosis of cervical spine injuries (CSI) in multitrauma patients, especially in the presence of head trauma, can be difficult. Identification of risk factors associated with CSI can help avoid missed or delayed diagnosis. Methods: Trauma registry study of pedestrian injuries caused by being hit by an automobile. Data abstracted for each patient included age, gender, Glasgow Coma Score on admission, Injury Severity Score, Abbreviated Injury Scale (AIS) for each body area, level of cervical spine injuries, and associated injuries. The incidence of spine injuries was derived for 4 age groups (14 years and younger, 15 to 55 years, 56 to 65 years, and older than 65 years). Logistic regression analysis was performed to identify risk factors associated with CSI. Results: There were 8,401 pedestrian injuries caused by automobiles, and 178 patients (2.1{\%}) had CSI. Incidence of CSI increased with age (0.3{\%} in the age group 14 years and younger, 2.2{\%} in the group 15 to 55 years, 3.7{\%} in the group 56 to 65 years, and 4.4{\%} in the group older than 65 years). Using the youngest age group (14 years and younger) as reference, relative risk of CSI in the other groups was 7.0, 12.1, and 14.2, respectively (p < 0.0001). Patients with severe head trauma (AIS > 3) were significantly more likely to have CSI than patients with less severe head injuries (AIS ≤ 3) (1.3{\%} versus 9.0{\%}, p < 0.0001). In the group of 5,040 injuries with no head trauma, there was not even a single case of CSI. Stepwise logistic regression analysis identified age, severe head injury (AIS > 3), severe chest trauma (AIS > 3), pelvic fracture, and femur fracture as independent risk factors for CSI. Conclusions: Incidence of CSI after injuries to pedestrians hit by automobiles increases with age and severity of head trauma. Age, severe head trauma, severe chest trauma, pelvic fracture, and femur fractures are independent predictors of CSI.",
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AU - Salim, Ali

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AU - Rhee, Peter M

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N2 - Background: Diagnosis of cervical spine injuries (CSI) in multitrauma patients, especially in the presence of head trauma, can be difficult. Identification of risk factors associated with CSI can help avoid missed or delayed diagnosis. Methods: Trauma registry study of pedestrian injuries caused by being hit by an automobile. Data abstracted for each patient included age, gender, Glasgow Coma Score on admission, Injury Severity Score, Abbreviated Injury Scale (AIS) for each body area, level of cervical spine injuries, and associated injuries. The incidence of spine injuries was derived for 4 age groups (14 years and younger, 15 to 55 years, 56 to 65 years, and older than 65 years). Logistic regression analysis was performed to identify risk factors associated with CSI. Results: There were 8,401 pedestrian injuries caused by automobiles, and 178 patients (2.1%) had CSI. Incidence of CSI increased with age (0.3% in the age group 14 years and younger, 2.2% in the group 15 to 55 years, 3.7% in the group 56 to 65 years, and 4.4% in the group older than 65 years). Using the youngest age group (14 years and younger) as reference, relative risk of CSI in the other groups was 7.0, 12.1, and 14.2, respectively (p < 0.0001). Patients with severe head trauma (AIS > 3) were significantly more likely to have CSI than patients with less severe head injuries (AIS ≤ 3) (1.3% versus 9.0%, p < 0.0001). In the group of 5,040 injuries with no head trauma, there was not even a single case of CSI. Stepwise logistic regression analysis identified age, severe head injury (AIS > 3), severe chest trauma (AIS > 3), pelvic fracture, and femur fracture as independent risk factors for CSI. Conclusions: Incidence of CSI after injuries to pedestrians hit by automobiles increases with age and severity of head trauma. Age, severe head trauma, severe chest trauma, pelvic fracture, and femur fractures are independent predictors of CSI.

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