Evidence map›Paper›PMID 32517132›Full record

ArticleJournal of clinical medicine2020

Early Spinal Injury Stabilization in Multiple-Injured Patients: Do All Patients Benefit?

Philipp Kobbe, Patrick Krug, Hagen Andruszkow, Miguel Pishnamaz, Martijn Hofman, Klemens Horst, Carolin Meyer, Max Joseph Scheyerer, Christoph Faymonville, Gregor Stein and 2 more

Abstract read
In one paragraph

Article in Journal of clinical medicine, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. ESTES recommendation on thoracolumbar spine fractures : January 2023.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2024
    Review
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Philipp KobbeDepartment for Trauma and Reconstructive Surgery, RWTH Aachen University Hospital, Pauwelsstraße 30, 52074 Aachen, Germany.
Patrick KrugDepartment of Orthopedics and Trauma Surgery, Rhein-Maas Klinikum GmbH, Mauerfeldchen 25, 52146 Wuerselen, Germany.
Hagen AndruszkowDepartment for Trauma and Reconstructive Surgery, RWTH Aachen University Hospital, Pauwelsstraße 30, 52074 Aachen, Germany.
Miguel PishnamazDepartment for Trauma and Reconstructive Surgery, RWTH Aachen University Hospital, Pauwelsstraße 30, 52074 Aachen, Germany.
Martijn HofmanDepartment for Trauma and Reconstructive Surgery, RWTH Aachen University Hospital, Pauwelsstraße 30, 52074 Aachen, Germany.ORCID 0000-0002-9914-8720
Klemens HorstDepartment for Trauma and Reconstructive Surgery, RWTH Aachen University Hospital, Pauwelsstraße 30, 52074 Aachen, Germany.
Carolin MeyerDepartment of Medicine, University of Cologne, Joseph-Stelzmann-Str. 24, 50931 Cologne, Germany.
Max Joseph ScheyererDepartment of Medicine, University of Cologne, Joseph-Stelzmann-Str. 24, 50931 Cologne, Germany.
Christoph FaymonvilleDepartment of Medicine, University of Cologne, Joseph-Stelzmann-Str. 24, 50931 Cologne, Germany.
Gregor SteinDepartment of Orthopedics, Trauma and Spine Surgery, Helios Hospital Siegburg, Ringstraße 49, 53721 Siegburg, Germany.ORCID 0000-0002-0443-4573
Frank HildebrandDepartment for Trauma and Reconstructive Surgery, RWTH Aachen University Hospital, Pauwelsstraße 30, 52074 Aachen, Germany.
Christian HerrenDepartment for Trauma and Reconstructive Surgery, RWTH Aachen University Hospital, Pauwelsstraße 30, 52074 Aachen, Germany.ORCID 0000-0002-9523-7005

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThoracolumbar spine fractures in multiple-injured patients are a common injury pattern. The appropriate timing for the surgical stabilization of vertebral fractures is still controversial. The purpose of this study was to analyse the impact of the timing of spinal surgery in multiple-injured patients both in general and in respect to spinal injury severity.

methodsA retrospective analysis of multiple-injured patients with an associated spinal trauma within the thoracic or lumbar spine (injury severity score (ISS) >16, age >16 years) was performed from January 2012 to December 2016 in two Level I trauma centres. Demographic data, circumstances of the accident, and ISS, as well as time to spinal surgery were documented. The evaluated outcome parameters were length of stay in the intensive care unit (ICU) (iLOS) and length of stay (LOS) in the hospital, duration of mechanical ventilation, onset of sepsis, and multiple organ dysfunction syndrome (MODS), as well as mortality. Statistical analysis was performed using SPSS.

resultsA total of 113 multiple-injured patients with spinal stabilization and a complete dataset were included in the study. Of these, 71 multiple-injured patients (63%) presented with an AOSpine A-type spinal injury, whereas 42 (37%) had an AOSpine B-/C-type spinal injury. Forty-nine multiple-injured patients (43.4%) were surgically treated for their spinal injury within 24 h after trauma, and showed a significantly reduced length of stay in the ICU (7.31 vs. 14.56 days;

conclusionOur data support the concept of early spinal stabilization in multiple-injured patients with AOSpine B-/C-type injuries, especially of the thoracic spine. However, in multiple-injured patients with AOSpine A-type injuries, the beneficial impact of early spinal stabilization has been overemphasized in former studies, and the benefit should be weighed out against the risk of patients' deterioration during early spinal stabilization.

Indexed as

AOSpine classificationmultiple-injured patientsepsisspine injurytime to surgery

Identifiers

PMID32517132
PMCPMC7356187

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.