Cardiac risk stratification and adverse outcomes in surgically managed patients with isolated traumatic spine injuries

Authors

Ahmad Mohammad Ismail, School of Medical Sciences, Orebro University, 701 82, Orebro, Sweden.
Maximilian Peter Forssten, School of Medical Sciences, Orebro University, 701 82, Orebro, Sweden.
Frank Hildebrand, Department of Orthopedics, Trauma and Reconstructive Surgery, University Hospital RWTH Aachen, Pauwelsstrasse 30, 52074, Aachen, Germany.
Babak Sarani, Center of Trauma and Critical Care, George Washington University, Washington, DC, USA.
Ioannis Ioannidis, School of Medical Sciences, Orebro University, 701 82, Orebro, Sweden.
Yang Cao, Clinical Epidemiology and Biostatistics, School of Medical Sciences, Faculty of Medicine and Health, Orebro University, 701 82, Orebro, Sweden.
Marcelo A. Ribeiro, Division of Trauma, Critical Care & Acute Care Surgery, Department of Surgery, Sheikh Shakhbout Medical City, Mayo Clinic, Abu Dhabi, United Arab Emirates.
Shahin Mohseni, School of Medical Sciences, Orebro University, 701 82, Orebro, Sweden. mohsenishahin@yahoo.com.

Document Type

Journal Article

Publication Date

4-1-2024

Journal

European journal of trauma and emergency surgery : official publication of the European Trauma Society

Volume

50

Issue

2

DOI

10.1007/s00068-023-02413-7

Keywords

Cardiopulmonary complications; Mortality; Revised Cardiac Risk Index; Risk stratification; Traumatic spine injury

Abstract

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.

APA Citation

Mohammad Ismail, Ahmad; Forssten, Maximilian Peter; Hildebrand, Frank; Sarani, Babak; Ioannidis, Ioannis; Cao, Yang; Ribeiro, Marcelo A.; and Mohseni, Shahin, "Cardiac risk stratification and adverse outcomes in surgically managed patients with isolated traumatic spine injuries" (2024). GW Authored Works. Paper 4843.
https://hsrc.himmelfarb.gwu.edu/gwhpubs/4843

Department

Surgery