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European Journal of Trauma and Emergency Surgery

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Open Access 03-01-2024 | Original Article

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

Authors: Ahmad Mohammad Ismail, Maximilian Peter Forssten, Frank Hildebrand, Babak Sarani, Ioannis Ioannidis, Yang Cao, Marcelo A. F. Ribeiro Jr., Shahin Mohseni

Published in: European Journal of Trauma and Emergency Surgery | Issue 2/2024

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.

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Title: Cardiac risk stratification and adverse outcomes in surgically managed patients with isolated traumatic spine injuries
Authors: Ahmad Mohammad Ismail
Maximilian Peter Forssten
Frank Hildebrand
Babak Sarani
Ioannis Ioannidis
Yang Cao
Marcelo A. F. Ribeiro Jr.
Shahin Mohseni
Publication date: 03-01-2024
Publisher: Springer Berlin Heidelberg
Published in: European Journal of Trauma and Emergency Surgery / Issue 2/2024
Print ISSN: 1863-9933
Electronic ISSN: 1863-9941
DOI: https://doi.org/10.1007/s00068-023-02413-7

Keynote webinar | Spotlight on medication adherence

Springer Medicine

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

Abstract

Introduction

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Introduction

Methods

Results

Conclusion

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