Unger B, Sarfati A, Botrel T, Pascal-Moussellard H, Raux M, James A, Marie-Hardy L
Orthopaedic surgery department, Pitié-Salpétrière Hospital, 43-87 boulevard de l'Hôpital 75013 Paris, France.
Anaesthesiology department, Pitié-Salpétrière Hospital, 43-87 boulevard de l'Hôpital 75013 Paris, France.
Injury. 2025 Jun;56(6):112319. doi: 10.1016/j.injury.2025.112319. Epub 2025 Apr 1.
Traumatic spinal injuries are a significant public health issue due to their high frequency and severity, impacting the entire healthcare system, especially when neurological sequelae are involved. These injuries require comprehensive resuscitative management, prioritizing spinal injuries within the context of associated injuries. Understanding the epidemiology of spinal fractures in polytraumatized patients is essential for improving care planning, primary prevention methods, and hospital management.
This retrospective, single-center, observational study used the TRAUMABASE database from 2018 to 2022 to provide an epidemiological overview of polytraumatized patients with spinal fractures treated in a level I trauma center. Patients admitted to the Post-Anesthesia Care Unit (PACU) with at least one spinal fracture were included, excluding those with isolated transverse process fractures or incomplete clinical files. Data collected included demographics, injury mechanism, Injury Severity Score (ISS), type of spinal lesion, Glasgow Coma Scale (GCS), surgical management, length of hospital stay, and mortality.
From 2018 to 2022, 561 patients with spinal fractures in the context of polytrauma were treated, with 386 patient records analyzed after exclusions. The mean age was 43 years, with a majority being male (75.1 %). The main injury mechanisms were falls from height (47.7 %) and traffic road accidents (46.4 %). Spinal surgery was performed on 53 % of patients, with a mean delay of 2.8 days from trauma to surgery. The overall mortality rate was 14.8 %, with neurological impairment, higher age, higher ISS score, lower GCS score, and absence of spinal surgery as unfavorable prognostic factors. The mean cost of hospitalization per patients was 76.854 ± 53.719 euros [3.502; 65.6623].
This study highlights the severity of polytraumatized patients with spinal lesions, with a mean ISS score of 24.4 and frequent associated severe traumatic brain injuries. The main injury mechanisms were falls from height and traffic road accidents, with a high representation of self-inflicted injuries. Overall, the study provides valuable insights into the management and outcomes of polytraumatized patients with spinal injuries.
创伤性脊柱损伤因其高发性和严重性，成为一个重大的公共卫生问题，对整个医疗系统都有影响，尤其是涉及神经后遗症时。这些损伤需要全面的复苏管理，在合并损伤的情况下优先处理脊柱损伤。了解多发伤患者脊柱骨折的流行病学对于改善护理计划、一级预防方法和医院管理至关重要。
这项回顾性、单中心观察性研究使用了2018年至2022年的TRAUMABASE数据库，以提供在一级创伤中心接受治疗的多发伤合并脊柱骨折患者的流行病学概况。纳入入住麻醉后护理单元（PACU）且至少有一处脊柱骨折的患者，排除单纯横突骨折或临床资料不完整的患者。收集的数据包括人口统计学信息、损伤机制、损伤严重程度评分（ISS）、脊柱损伤类型、格拉斯哥昏迷量表（GCS）、手术治疗、住院时间和死亡率。
2018年至2022年，共治疗了561例多发伤合并脊柱骨折的患者，排除后分析了386例患者的记录。平均年龄为43岁，大多数为男性（75.1%）。主要损伤机制为高处坠落（47.7%）和交通事故（46.4%）。53%的患者接受了脊柱手术，从创伤到手术的平均延迟时间为2.8天。总死亡率为14.8%，神经功能障碍、年龄较大、ISS评分较高、GCS评分较低以及未进行脊柱手术是不良预后因素。每位患者的平均住院费用为76,854±53,719欧元[3,502；65,6623]。
本研究突出了多发伤合并脊柱损伤患者的严重性，平均ISS评分为24.4，且常伴有严重的创伤性脑损伤。主要损伤机制为高处坠落和交通事故，自残伤的比例较高。总体而言，该研究为多发伤合并脊柱损伤患者的管理和结局提供了有价值的见解。
