Vertebral artery injury after cervical trauma may increase risk of complications
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Patients with cervical spine trauma who had a vertebral artery injury had risk-adjusted increased odds of complications, unplanned procedures and longer length of stay, according to results.
Using the National Trauma Databank, Romil Shah, MD, and colleagues collected information about demographics, injury characteristics and presence of vertebral artery injury for patients who experienced cervical spine trauma from 2016 to 2017. Researchers also collected data on complications, including myocardial infarction, cerebrovascular accident, deep vein thrombosis and pulmonary embolism.
“We also collected length of stay, both in the ICU and total length of stay, [and] unplanned surgical procedures or unplanned ICU admissions,” Shah said in his presentation at the North American Spine Society Annual Meeting.
Among the 128,908 patients identified with cervical spine trauma, Shah noted 4.11% of these patients had a vertebral artery injury. Univariate analysis results showed patients with vertebral artery injury had a significantly higher risk of myocardial infarction, cerebrovascular accident, deep vein thrombosis, pulmonary embolism, neurologic injury and hemorrhage. Shah added patients with vertebral artery injury also had significantly higher risks of unplanned ICU admissions, unplanned surgical procedures and longer length of stay.
After adjusting for age, gender, race, injury severity and patient comorbidities, multivariate analysis showed patients with vertebral artery injury had a 2.1-fold increased odds of complications, according to Shah.
“After that same risk adjustment, [vertebral artery injury] VAI was associated with a 2.1-fold increased odds of unplanned ICU admissions and unplanned surgical procedures,” Shah said. “After risk adjustment, again, VAI was associated with a 2.3-fold increased odds of length of stay greater than 8 days and 2.8-fold increased odds of ICU length of stay greater than 3 days.”
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Shah R, et al. Paper 261. Presented at: North American Spine Society Annual Meeting. Sept. 29 - Oct. 2, 2021; Boston (hybrid meeting).
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