학술논문
Concomitant spine trauma in patients with traumatic brain injury: Patient characteristics and outcomes
Document Type
article
Author
Lennart Riemann; Obada T. Alhalabi; Andreas W. Unterberg; Alexander Younsi; The CENTER-TBI investigators and participants; Cecilia Åkerlund; Krisztina Amrein; Nada Andelic; Lasse Andreassen; Audny Anke; Anna Antoni; Gérard Audibert; Philippe Azouvi; Maria Luisa Azzolini; Ronald Bartels; Pál Barzó; Romuald Beauvais; Ronny Beer; Bo-Michael Bellander; Antonio Belli; Habib Benali; Maurizio Berardino; Luigi Beretta; Morten Blaabjerg; Peter Bragge; Alexandra Brazinova; Vibeke Brinck; Joanne Brooker; Camilla Brorsson; Andras Buki; Monika Bullinger; Manuel Cabeleira; Alessio Caccioppola; Emiliana Calappi; Maria Rosa Calvi; Peter Cameron; Guillermo Carbayo Lozano; Marco Carbonara; Simona Cavallo; Giorgio Chevallard; Arturo Chieregato; Giuseppe Citerio; Hans Clusmann; Mark Coburn; Jonathan Coles; Jamie D. Cooper; Marta Correia; Amra Cović; Nicola Curry; Endre Czeiter; Marek Czosnyka; Claire Dahyot-Fizelier; Paul Dark; Helen Dawes; Véronique De Keyser; Vincent Degos; Francesco Della Corte; Hugo den Boogert; Bart Depreitere; Ðula Ðilvesi; Abhishek Dixit; Emma Donoghue; Jens Dreier; Guy-Loup Dulière; Ari Ercole; Patrick Esser; Erzsébet Ezer; Martin Fabricius; Valery L. Feigin; Kelly Foks; Shirin Frisvold; Alex Furmanov; Pablo Gagliardo; Damien Galanaud; Dashiell Gantner; Guoyi Gao; Pradeep George; Alexandre Ghuysen; Lelde Giga; Ben Glocker; Jagoš Golubovic; Pedro A. Gomez; Johannes Gratz; Benjamin Gravesteijn; Francesca Grossi; Russell L. Gruen; Deepak Gupta; Juanita A. Haagsma; Iain Haitsma; Raimund Helbok; Eirik Helseth; Lindsay Horton; Jilske Huijben; Peter J. Hutchinson; Bram Jacobs; Stefan Jankowski; Mike Jarrett; Ji-yao Jiang; Faye Johnson; Kelly Jones; Mladen Karan; Angelos G. Kolias; Erwin Kompanje; Daniel Kondziella; Evgenios Kornaropoulos; Lars-Owe Koskinen; Noémi Kovács; Ana Kowark; Alfonso Lagares; Linda Lanyon; Steven Laureys; Fiona Lecky; Didier Ledoux; Rolf Lefering; Valerie Legrand; Aurelie Lejeune; Leon Levi; Roger Lightfoot; Hester Lingsma; Andrew I.R. Maas; Ana M. Castaño-León; Marc Maegele; Marek Majdan; Alex Manara; Geoffrey Manley; Costanza Martino; Hugues Maréchal; Julia Mattern; Catherine McMahon; Béla Melegh; David Menon; Tomas Menovsky; Ana Mikolic; Benoit Misset; Visakh Muraleedharan; Lynnette Murray; Ancuta Negru; David Nelson; Virginia Newcombe; Daan Nieboer; József Nyirádi; Otesile Olubukola; Matej Oresic; Fabrizio Ortolano; Aarno Palotie; Paul M. Parizel; Jean-François Payen; Natascha Perera; Vincent Perlbarg; Paolo Persona; Wilco Peul; Anna Piippo-Karjalainen; Matti Pirinen; Dana Pisica; Horia Ples; Suzanne Polinder; Inigo Pomposo; Jussi P. Posti; Louis Puybasset; Andreea Radoi; Arminas Ragauskas; Rahul Raj; Malinka Rambadagalla; Isabel Retel Helmrich; Jonathan Rhodes; Sylvia Richardson; Sophie Richter; Samuli Ripatti; Saulius Rocka; Cecilie Roe; Olav Roise; Jonathan Rosand; Jeffrey V. Rosenfeld; Christina Rosenlund; Guy Rosenthal; Rolf Rossaint; Sandra Rossi; Daniel Rueckert; Martin Rusnák; Juan Sahuquillo; Oliver Sakowitz; Renan Sanchez-Porras; Janos Sandor; Nadine Schäfer; Silke Schmidt; Herbert Schoechl; Guus Schoonman; Rico Frederik Schou; Elisabeth Schwendenwein; Charlie Sewalt; Ranjit D. Singh; Toril Skandsen; Peter Smielewski; Abayomi Sorinola; Emmanuel Stamatakis; Simon Stanworth; Robert Stevens; William Stewart; Ewout W. Steyerberg; Nino Stocchetti; Nina Sundström; Riikka Takala; Viktória Tamás; Tomas Tamosuitis; Mark Steven Taylor; Braden Te Ao; Olli Tenovuo; Alice Theadom; Matt Thomas; Dick Tibboel; Marjolein Timmers; Christos Tolias; Tony Trapani; Cristina Maria Tudora; Andreas Unterberg; Peter Vajkoczy; Shirley Vallance; Egils Valeinis; Zoltán Vámos; Mathieu van der Jagt; Gregory Van der Steen; Joukje van der Naalt; Jeroen T.J.M. van Dijck; Inge A. van Erp; Thomas A. van Essen; Wim Van Hecke; Caroline van Heugten; Dominique Van Praag; Ernest van Veen; Thijs Vande Vyvere; Roel P. J. van Wijk; Alessia Vargiolu; Emmanuel Vega; Kimberley Velt; Jan Verheyden; Paul M. Vespa; Anne Vik; Rimantas Vilcinis; Victor Volovici; Nicole von Steinbüchel; Daphne Voormolen; Petar Vulekovic; Kevin K.W. Wang; Daniel Whitehouse; Eveline Wiegers; Guy Williams; Lindsay Wilson; Stefan Winzeck; Stefan Wolf; Zhihui Yang; Peter Ylén; Frederick A. Zeiler; Veronika Zelinkova; Agate Ziverte; Tommaso Zoerle
Source
Frontiers in Neurology, Vol 13 (2022)
Subject
Language
English
ISSN
1664-2295
Abstract
ObjectiveSpine injury is highly prevalent in patients with poly-trauma, but data on the co-occurrence of spine trauma in patients with traumatic brain injury (TBI) are scarce. In this study, we used the Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) database to assess the prevalence, characteristics, and outcomes of patients with TBI and a concurrent traumatic spinal injury (TSI).MethodsData from the European multi-center CENTER-TBI study were analyzed. Adult patients with TBI (≥18 years) presenting with a concomitant, isolated TSI of at least serious severity (Abbreviated Injury Scale; AIS ≥3) were included. For outcome analysis, comparison groups of TBI patients with TSI and systemic injuries (non-isolated TSI) and without TSI were created using propensity score matching. Rates of mortality, unfavorable outcomes (Glasgow Outcome Scale Extended; GOSe < 5), and full recovery (GOSe 7–8) of all patients and separately for patients with only mild TBI (mTBI) were compared between groups at 6-month follow-up.ResultsA total of 164 (4%) of the 4,254 CENTER-TBI core study patients suffered from a concomitant isolated TSI. The median age was 53 [interquartile range (IQR): 37–66] years and 71% of patients were men. mTBI was documented in 62% of cases, followed by severe TBI (26%), and spine injuries were mostly cervical (63%) or thoracic (31%). Surgical spine stabilization was performed in 19% of cases and 57% of patients were admitted to the ICU. Mortality at 6 months was 11% and only 36% of patients regained full recovery. There were no significant differences in the 6-month rates of mortality, unfavorable outcomes, or full recovery between TBI patients with and without concomitant isolated TSI. However, concomitant non-isolated TSI was associated with an unfavorable outcome and a higher mortality. In patients with mTBI, a negative association with full recovery could be observed for both concomitant isolated and non-isolated TSI.ConclusionRates of mortality, unfavorable outcomes, and full recovery in TBI patients with and without concomitant, isolated TSIs were comparable after 6 months. However, in patients with mTBI, concomitant TSI was a negative predictor for a full recovery. These findings might indicate that patients with moderate to severe TBI do not necessarily exhibit worse outcomes when having a concomitant TSI, whereas patients with mTBI might be more affected.