gms | German Medical Science

Objectives: Early stabilization of the spine in severely injured patients aims to reduce ventilation time, rate of pneumonia as well as hospital stay without increasing injury-related complications rates. The aim of this study was to assess the influence of stabilization of the spine on the outcome of severely injured patients.

Methods: This study retrospectively analyses patients who are included in our trauma database. Inclusion criteria were ages 16 years and higher, an injury severity score 16 and higher and injuries to at least two body regions. The groups with and without surgical intervention at the spine were compared. Surgery of the spine was stratified into three time-points with regard to the day of the injury: immediately (day of admission), early (within 48 hours) and delayed stabilization (>48h).

Results: We included 2665 patients in this study. The group without spine injury counts 7 patients; 2355 patients with spine injury don't need or get any spine surgery. The remaining 303 patients who were surgically stabilized due to spine injury were divided according to the timepoint of stabilization: Immediately (n=141), early (n=68) and delayed (n=94). The group with delayed surgical intervention on the spine showed highest length of stay (LOS) in hospital (27 ± 14 days) as well as ICU LOS (15±11 days) and ventilation days (10±11 days). There was no significant differences in mortality the groups without injuries to the spine or immediate versus early stabilization. The mortality rate within the operated spine-groups were 5.0%, 5.9% and 5.3%. The rate of pneumonia, infection and sepsis was highest and significant different in the group with delayed stabilization (33.0 - 53.8% vs. 13.4 - 34.1%)

Conclusion: Our data suggest a similar ventilation time as well as hospitalization time, when injuries to the spine are surgically stabilized within 48 hours compared to multiple injured patients without instable spine injures. The time to stabilization of the spine, however, does not seem to have an influence on mortality rate, but on infectious complication. Based on these data, we recommend stabilization spinal injuries within 48 hours as long as the general status of the injured patient allows this intervention.