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Cardiac risk stratification and adverse outcomes in surgically managed patients with isolated traumatic spine injuries
Örebro University, School of Medical Sciences. Örebro University Hospital.ORCID iD: 0000-0003-3436-1026
Örebro University, School of Medical Sciences. Department of Orthopedic Surgery, Örebro University Hospital, Örebro, Sweden.ORCID iD: 0000-0003-3583-3443
Department of Orthopedics, Trauma and Reconstructive Surgery, University Hospital RWTH Aachen, Aachen, Germany.
Center of Trauma and Critical Care, George Washington University, Washington, DC, USA.
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2024 (English)In: European Journal of Trauma and Emergency Surgery, ISSN 1863-9933, E-ISSN 1863-9941Article in journal (Refereed) Epub ahead of print
Abstract [en]

INTRODUCTION: As the incidence of traumatic spine injuries has been steadily increasing, especially in the elderly, the ability to categorize patients based on their underlying risk for the adverse outcomes could be of great value in clinical decision making. This study aimed to investigate the association between the Revised Cardiac Risk Index (RCRI) and adverse outcomes in patients who have undergone surgery for traumatic spine injuries.

METHODS: All adult patients (18 years or older) in the 2013-2019 TQIP database with isolated spine injuries resulting from blunt force trauma, who underwent spinal surgery, were eligible for inclusion in the study. The association between the RCRI and in-hospital mortality, cardiopulmonary complications, and failure-to-rescue (FTR) was determined using Poisson regression models with robust standard errors to adjust for potential confounding.

RESULTS: A total of 39,391 patients were included for further analysis. In the regression model, an RCRI ≥ 3 was associated with a threefold risk of in-hospital mortality [adjusted IRR (95% CI): 3.19 (2.30-4.43), p < 0.001] and cardiopulmonary complications [adjusted IRR (95% CI): 3.27 (2.46-4.34), p < 0.001], as well as a fourfold risk of FTR [adjusted IRR (95% CI): 4.27 (2.59-7.02), p < 0.001], compared to RCRI 0. The risk of all adverse outcomes increased stepwise along with each RCRI score.

CONCLUSION: The RCRI may be a useful tool for identifying patients with traumatic spine injuries who are at an increased risk of in-hospital mortality, cardiopulmonary complications, and failure-to-rescue after surgery.

Place, publisher, year, edition, pages
Urban und Vogel Medien und Medizin Verlagsgesellsc , 2024.
Keywords [en]
Cardiopulmonary complications, Mortality, Revised Cardiac Risk Index, Risk stratification, Traumatic spine injury
National Category
Cardiac and Cardiovascular Systems
Identifiers
URN: urn:nbn:se:oru:diva-110622DOI: 10.1007/s00068-023-02413-7ISI: 001135545400001PubMedID: 38170276Scopus ID: 2-s2.0-85181522328OAI: oai:DiVA.org:oru-110622DiVA, id: diva2:1825386
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Örebro UniversityAvailable from: 2024-01-09 Created: 2024-01-09 Last updated: 2024-03-06Bibliographically approved

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Mohammad Ismail, AhmadForssten, Maximilian PeterIoannidis, IoannisCao, YangMohseni, Shahin

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European Journal of Trauma and Emergency Surgery
Cardiac and Cardiovascular Systems

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