Background
Methods
Database
Patient selection
Inclusion criteria
Exclusion criteria
Statistical analysis
Results
Demographics
Total | No Surgery (NSI) n = 402 | Early Surgery (ESI) n = 976 | Late Surgery (LSI) n = 362 | P-value (ESI versus LSI) | |
---|---|---|---|---|---|
Male gender | 76.2 (1320) | 76.5 (306) | 76.2 (739) | 76.0 (275) | 0.98 |
Mean age | 48.0 (SD 18.7) | 51.2 (SD 20.1) | 45.9 (SD 17.6) | 50.1 (SD 19.1) | < 0.001 |
Mean ISS | 26.6 (SD 9.6) | 26.5 (SD 10.6) | 27.5 (SD 9.3) | 25.6 (SD 8.9) | 0.001 |
ISS ≥ 25 | 59.8 (1041) | 53.2 (214) | 65.3 (637) | 52.2 (190) | < 0.001 |
RRsys ≤ 90 mmHg prehospital | 16.2 (214) | 22.2 (66) | 13.4 (99) | 17.0 (49) | 0.002 |
RRsys ≤ 90 mmHg on admission | 13.4 (218) | 16.7 (60) | 11.8 (108) | 14.6 (50) | 0.051 |
Need for blood transfusion | 17.2 (299) | 15.8 (63) | 18.3 (179) | 15.7 (57) | 0.36 |
Need for thoracic drain prehospital | 5.4 (78) | 6.6 (22) | 4.9 (39) | 5.6 (17) | 0.52 |
Need for thoracic drain trauma room | 26.7 (456) | 29.7 (115) | 26.3 (255) | 24.3 (86) | 0.23 |
Mortality
Total | No Surgery (NSI) | Early Surgery (ESI) | Late Surgery (LSI) | |
---|---|---|---|---|
Mortality within the first 24 h | 2.2% (39) | 9.0% (36) | 0.3% (3) | (none) |
Mortality during hospital stay | 6.5% (113) | 17.9% (72) | 3.5% (34) | 1.9% (7) |
RISC II prognosis | 8.3% | 14.0% | 5.9% | 8.2% |
Surgical therapy
Total | No Surgery (NSI) | Early Surgery (ESI) | Late Surgery (LSI) | |
---|---|---|---|---|
Fracture of the thoracic spine AIS ≥ 3 | 69.1 (1188) | 24.8 (295) | 54.7 (650) | 20.5 (243) |
AIS TS = 3 | 51.8 (685) | 29.2 (200) | 43.2 (296) | 27.6 (189) |
AIS TS = 4 | 14.8 (61) | 23.0 (14) | 59.0 (36) | 18.0 (11) |
AIS TS = 5 | 33.4 (442) | 18.3 (81) | 71.9 (318) | 9.7 (43) |
Fracture of the lumbar spine AIS ≥ 3 | 37.6 (645) | 22.5 (145) | 55.8 (360) | 21.7 (140) |
AIS LS = 3 | 75.0 (484) | 24.6 (119) | 49.4 (239) | 46.0 (126) |
AIS LS = 4 | 9.6 (62) | 17.7 (11) | 74.2 (46) | 8.1 (5) |
AIS LS = 5 | 15.4 (99) | 15.2 (15) | 75.8 (75) | 9.1 (9) |
Thoracic spine (TS); AISTS = 3
No Surgery (NSI) n = 180 | Early Surgery (ESI) n = 295 | Late Surgery (LSI) n = 189 | P-value (ESI versus LSI) | |
---|---|---|---|---|
Mean ISS | 22.0 | 20.3 | 21.8 | 0.12 |
Days on ventilator | 5.1 [1] | 5.6 [1] | 8.4 [1] | 0.21 |
Days on ICU | 9.0 [5] | 10.4 [6] | 14.5 [9] | 0.004 |
Days in hospital | 20.6 [17] | 23.9 [20] | 31.0 [26] | < 0.001 |
MOF | 26.3 (40) | 20.4 (56) | 39.0 (67) | < 0.001 |
Lung failure (ARDS) | 24.3 (37) | 21.2 (58) | 30.2 (52) | 0.031 |
Sepsis | 9.7 (14) | 6.8 (18) | 12.4 (21) | 0.045 |
Blood transfusion | 11.7 (21) | 9.8 (29) | 13.2 (25) | 0.25 |
GOS 3 | 8.2 (14) | 5.1 (15) | 12.2 (23) | 0.003 |
GOS 4 | 22.4 (38) | 22.3 (65) | 31.2 (59) | |
GOS 5 | 55.3 (94) | 68.5 (200) | 54.5 (103) |
No Surgery (NSI) n = 180 | Early Surgery (ESI) n = 295 | Late Surgery (LSI) n = 189 | |
---|---|---|---|
AIS Thorax = 3 | 67.2 (121) | 62.7 (185) | 63.0 (119) |
AIS Thorax = 4 | 18.3 (33) | 25.1 (74) | 20.1 (38) |
AIS Thorax = 5 | 14.5 (26) | 12.2 (36) | 16.9 (32) |
Thoracic spine (TS); AISTS = 4/5
No Surgery (NSI) n = 82 | Early Surgery (ESI) n = 353 | Late Surgery (LSI) n = 54 | P-value (ESI versus LSI) | |
---|---|---|---|---|
Mean ISS | 31.7 | 31.6 | 32.5 | 0.19 |
Days on ventilator | 9.2 [5] | 8.0 [3] | 13.7 [9] | 0.038 |
Days on ICU | 14.6 [13] | 14.4 [11] | 21.1 [19] | 0.002 |
Days in hospital | 39.9 [22] | 32.0 [19] | 37.4 [34] | < 0.001 |
MOF | 37.3 (25) | 35.4 (120) | 44.7 (21) | 0.22 |
Lung failure (ARDS) | 32.8 (22) | 31.0 (105) | 38.3 (18) | 0.31 |
Sepsis | 7.7 (5) | 10.4 (35) | 21.7 (10) | 0.026 |
Blood transfusion | 15.9 (13) | 26.3 (93) | 20.4 (11) | 0.35 |
GOS 2 | 1.4% (1) | 0.9 (3) | 0 (0) | 0.063 |
GOS 3 | 54.1 (40) | 57.4 (194) | 40.7 (22) | |
GOS 4 | 16.2 (12) | 21.0 (71) | 33.3 (18) | |
GOS 5 | 14.9 (11) | 15.7 (53) | 24.1 (13) |
Lumbar spine (LS); AISLS = 3
No Surgery (NSI) n = 114 | Early Surgery (ESI) n = 239 | Late Surgery (LSI) n = 126 | P-value (ESI versus LSI) | |
---|---|---|---|---|
Mean ISS | 25.9 | 25.2 | 27.9 | 0.010 |
Days on ventilator | 4.1 [0] | 3.4 [1] | 5.3 [1] | 0.010 |
Days on ICU | 8.5 [4] | 8.4 [4] | 12.7 [10] | < 0.001 |
Days in hospital | 23.7 [17] | 24.4 [21] | 30.6 [25] | 0.001 |
MOF | 15.1 (14) | 17.3 (39) | 29.8 (34) | 0.008 |
Lung failure (ARDS) | 21.5 (20) | 16.4 (37) | 28.9 (33) | 0.007 |
Sepsis | 5.6 (5) | 5.3 (12) | 10.5 (12) | 0.076 |
Blood transfusion | 8.8 (10) | 10.5 (25) | 19.0 (24) | 0.022 |
GOS 2 | 0.9 (1) | 0 (0) | 0.8 (1) | 0.37 |
GOS 3 | 11.9 (13) | 5.1 (12) | 8.8 (11) | |
GOS 4 | 20.2 (22) | 25.4 (60) | 27.2 (34) | |
GOS 5 | 61.5 (67) | 67.4 (159) | 61.6 (77) |
No Surgery (NSI) n = 114 | Early Surgery (ESI) n = 239 | Late Surgery (LSI) n = 126 | |
---|---|---|---|
AISThorax = 3 | 67.5 (77) | 69.5 (166) | 63.5 (27) |
AISThorax = 4 | 23.7 (27) | 25.9 (62) | 21.4 (27) |
AISThorax = 5 | 8.8 (10) | 4.6 (11) | 15.1 (19) |
Lumbar spine (LS); AISLS = 4/5
No Surgery (NSI) n = 26 | Early Surgery (ESI) n = 120 | Late Surgery (LSI) n = 14 | P-value (ESI versus LSI) | |
---|---|---|---|---|
Mean ISS | 38.4 | 39.6 | 43.4 | 0.95 |
Days on ventilator | 3.6 [2] | 4.2 [1] | 7.1 [4] | 0.12 |
Days on ICU | 9.4 [7] | 12.7 [9] | 15.6 [14] | 0.13 |
Days in hospital | 47.2 [25] | 34.1 [26] | 29.5 [28] | 0.46 |
MOF | 28.0 (7) | 21.9 (25) | 46.2 (6) | 0.054 |
Lung failure (ARDS) | 12.0 (3) | 21.1 (24) | 38.5 (5) | 0.16 |
Sepsis | 0 (0) | 6.1 (7) | 15.4 (2) | 0.22 |
Blood transfusion | 19.2 (5) | 28.6 (34) | 7.7 (1) | 0.088 |
GOS 3 | 26.9 (7) | 36.8 (43) | 35.7 (5) | 0.26 |
GOS 4 | 38.5 (10) | 33.3 (39) | 21.4 (3) | |
GOS 5 | 34.6 (9) | 29.1 (34) | 35.7 (5) |