1258 - Associated injuries in patients with traumatic spinal cord injury

Friday, February 23, 2024

5:00 PM – 6:30 PM EDT

Presenting Author(s)

JQ

José E. Quintana Soler, MD

Resident Physician
University of Puerto Rico School of Medicine
San Juan, Puerto Rico, United States

Corresponding Author(s)

Manuel F. Mas, MD

Assistant Professor
University of Puerto Rico, School of Medicine
San Juan, Puerto Rico, United States

Co-Author(s)

JC

José Conde, MD, MPH

Professor
University of Puerto Rico, School of Medicine
San Juan, Puerto Rico, United States
NF

Natasha L. Frontera, BA

Medical student
University of Puerto Rico, Medical Sciences Campus
San Juan, Puerto Rico, United States
ML

Marcos R. Latimer, BS

Medical Student
University of Puerto Rico School of Medicine
San Juan, Puerto Rico, United States
JD

Javier E. Deya-Navarro, MS

Medical student
University of Puerto Rico, Medical Science Campus
Guaynabo, Puerto Rico, United States
AB

Anna V. Blanco-Cintrón, MD

Resident Physician
San Juan VA Medical Center
San Juan, Puerto Rico, United States
Walter Frontera, MD, PhD

Professor
University of Puerto Rico School of Medicine
San Juan, Puerto Rico, United States

Objectives: To assess the type and frequency injuries associated with traumatic spinal cord injuries (T-SCI) on admission at a single trauma hospital from 2019 to 2022.

Design: A retrospective analysis of 5,126 patients admitted from 1/1/2019 to 12/31/2022 and included in the trauma hospital registry. Cases with the following ICD-10-CM codes were identified: S10-S19 (injuries to the neck), S20-S29 (injuries to the thorax) and S30-S39 (injuries to the abdomen, lower back, lumbar spine, pelvis). Using this criteria, a total of 3,328 cases were reviewed for evidence of T-SCI. Final confirmation of the diagnosis was made by a single expert in physical medicine and rehabilitation and in trauma rehabilitation. Data collected included associated injuries on admission recorded as ICD-10-CM codes, as well as age, sex, level of injury, mechanism of injury, injury severity score (ISS) and length of stay.

Results: A total of 145 adult cases of T-SCI were identified. The most common associated injuries on admission included: fracture of rib(s), sternum and thoracic spine (93 patients; 64.1%), injury of other intrathoracic organs (87 patients; 60.0%) and fracture of cervical vertebra and other parts of neck (56 patients; 38.6%). Pneumo/hemothorax was diagnosed in 69 patients (57.6%). TBI coexisted with T-SCI in 41 patients (28.3%). Fracture of cervical and lumbar spine significantly correlated with cervical and lumbosacral injury levels, respectively. 139 patients (95.2%) had a diagnosis that could complicate rehabilitation (fracture of spine or upper/lower extremity, pneumo/hemothorax and TBI). Fractures in upper extremities (41 patients; 28.3%) were more common than in lower extremities (16 patients; 11.0%) . ISS showed a low, positive correlation with the number of associated injuries (Spearman: 0.28; p: < 0.001). Preliminary ROC analysis suggests that the ISS is not useful to identify patients with diagnoses complicating rehabilitation.

Conclusions: Associated injuries on admission with T-SCI are common and can challenge the rehabilitation process.