Epidemiology of cervical spine injury admitted to a trauma center in Hong Kong

Abstract

OBJECTIVES 1. To describe the epidemiology of patients admitted for cervical spine injuries in Princess Margaret Hospital. 2. To perform epidemiological analysis on the associated risk factors of cervical spinal cord injuries (cases) amongst cervical spine injuries using data in the Trauma Registry of Princess Margaret Hospital in Hong Kong with cervical spine injuries without cord involvement as controls. 3. To have a deeper understanding of the impact of cervical spinal cord injuries in terms of hospital length of stay and subsequent discharge status in the community of Kowloon West Cluster in Hong Kong.

METHODS A case-control study of 366 patients was conducted using data in the Trauma Registry of Princess Margaret Hospital in Hong Kong during a 6-year period from January 2008 to December 2013. The cases were patients admitted with cervical spinal cord injuries while the controls were patients admitted with cervical spine injuries only without cord involvement. Risk of cervical spine injuries with or without cord involvement, injury mechanisms, hospital length of stay and other patient characteristics were studied.

RESULTS The study identified a trend of increasing number of cervical spine injuries in the Kowloon West Cluster region of Hong Kong from January 2008 to December 2013. Motor vehicle collision (MVC) is the major cause of traumatic cervical spine injuries (47.3% of total, n=173). The second most common injury mechanism was fall (34.2% of total, n=125). The age group with the most cervical spine injuries was 40-59 years, n=166, 45% of total. There were no relationships between age and cervical spinal cord injury; gender and cervical spinal cord injury. There were also no relationships between injury mechanisms and cervical spinal cord injury, except for the mechanism “fall” (OR: 10.17, 95% CI 2.16-47.97, p<0.05) compared to MVC. Patients who were diagnosed of CSI with cord involvement had 17.5 days longer of hospital length of stay (95% CI 10.71 – 25.56, p< 0.001) compared with the non-cord injury group.

CONCLUSION Although MVC was the major injury mechanism in the region, fall incidents were associated with cervical spine injuries with cord involvement and longer hospital length of stay. A city-wide trauma registry is suggested to enhance the understanding of cervical spine injuries in the perspective of primary and secondary prevention. In addition, more studies should be done to identify the epidemiological characteristics for practice improvement and prevention plan.