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DOI: 10.1055/s-0031-1280679
© Thieme Medical Publishers
Do Concomitant Cranium and Axis Injuries Predict Worse Outcome? A Trauma Database Quantitative Analysis
Publication History
Publication Date:
22 June 2011 (online)
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ABSTRACT
We performed a trauma database analysis to identify the effect of concomitant cranial injuries on outcome in patients with fractures of the axis. We identified patients with axis fractures over a 14-year period. A binary outcome measure was used. Univariate and multiple logistic regression analysis were performed. There were 259 cases with axis fractures. Closed head injury was noted in 57% and skull base trauma in 14%. Death occurred in 17 cases (6%). Seventy-two percent had good outcome. Presence of abnormal computed tomography head findings, skull base fractures, and visceral injury was significantly associated with poor outcome. Skull base injury in association with fractures of the axis is a significant independent predictor of worse outcomes, irrespective of the severity of the head injury. We propose that presence of concomitant cranial and upper vertebral injuries require careful evaluation in view of the associated poor prognosis.
KEYWORDS
Cervical spine - axis fractures - craniovertebral junction - skull base - trauma database
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Anil NandaM.D. F.A.C.S.
Chair and Professor, Department of Neurosurgery
P.O. Box 33932, LSUHSC, Shreveport, LA 71130-3932
Email: ananda@lsuhsc.edu