Are Cervical CT Scans Necessary in All Intoxicated Trauma Patients: A Retrospective Evaluation of Predictors for C-Spine Injuries
Description
Current screening guidelines for intoxicated trauma patients favor the routine use of cervicalspine (c-spine) CT scans. The objective of this study was to identify parameters that predispose intoxicated trauma patients to c-spine injuries in order to refine diagnostic imaging utilization. A retrospective chart review of intoxicated adult trauma patients involved in motor vehicle collisions presenting to a Level I trauma center from March 2020-September 2021 was performed. Baseline demographics, protective devices, and Injury Severity Score (ISS) were assessed in patients with c-spine fractures or nerve root damage, diagnosed by clinical examination and imaging, compared to patients without injuries. Univariate and multivariate analyses were performed. Of 485 patients, 8% (N=40) had c-spine injuries. Patients between the ages of 45-64 years (p=0.007) or with an ISS between 16-49 (p≤0.03) were most likely to have c-spine injuries. While airbag deployment was similar between groups (p=0.7), the use of seatbelts or all three protective devices was associated with no injuries (p=0.01). On multivariate analysis, ISS (OR 1.07, 95% CI 1.04-1.10, p<0.001) and age (OR 1.04, 95% CI 1.01 to 1.06, p=0.003) were the greatest predictors of injuries. Intoxicated trauma patients were most at-risk for c-spine injuries if they were between the ages of 45-64 years or had an ISS between 16-49. This study suggests further analysis of these associations to refine c-spine imaging guidelines for intoxicated patients after motor vehicle trauma.
Are Cervical CT Scans Necessary in All Intoxicated Trauma Patients: A Retrospective Evaluation of Predictors for C-Spine Injuries
Current screening guidelines for intoxicated trauma patients favor the routine use of cervicalspine (c-spine) CT scans. The objective of this study was to identify parameters that predispose intoxicated trauma patients to c-spine injuries in order to refine diagnostic imaging utilization. A retrospective chart review of intoxicated adult trauma patients involved in motor vehicle collisions presenting to a Level I trauma center from March 2020-September 2021 was performed. Baseline demographics, protective devices, and Injury Severity Score (ISS) were assessed in patients with c-spine fractures or nerve root damage, diagnosed by clinical examination and imaging, compared to patients without injuries. Univariate and multivariate analyses were performed. Of 485 patients, 8% (N=40) had c-spine injuries. Patients between the ages of 45-64 years (p=0.007) or with an ISS between 16-49 (p≤0.03) were most likely to have c-spine injuries. While airbag deployment was similar between groups (p=0.7), the use of seatbelts or all three protective devices was associated with no injuries (p=0.01). On multivariate analysis, ISS (OR 1.07, 95% CI 1.04-1.10, p<0.001) and age (OR 1.04, 95% CI 1.01 to 1.06, p=0.003) were the greatest predictors of injuries. Intoxicated trauma patients were most at-risk for c-spine injuries if they were between the ages of 45-64 years or had an ISS between 16-49. This study suggests further analysis of these associations to refine c-spine imaging guidelines for intoxicated patients after motor vehicle trauma.