Factors Impacting Complications Development in Patients with Spine Fractures and Spinal Cord Injury

Introduction: Spinal fractures and spinal cord injury (SCI) are associated with a high risk of complications. This study aims to determine which factors increase the odds of developing complications in patients with spinal fractures and SCI

Methods: A retrospective cohort study was conducted using data from the National Trauma Databank (2017–2022) on patients with spinal fractures and SCI, focusing on the impact of Injury Severity Score (ISS), age, Charleston Comorbidity Index (CCI), insurance status, and surgical intervention. Complication rates were calculated for cervical and thoracic levels. Logistic regression analysis was performed to identify predictors of complications, including cardiovascular, infectious, pressure/immobilization-related, respiratory, and delirium.

Results: Cervical SCI patients had the highest overall complication rate (63.8%), followed by thoracic SCI (36.2%). Cervical LOI had the highest odds of complications across all complication categories. A CCI score (1-2) significantly increased the odds of developing complications in nearly all categories, including cardiovascular (OR 1.84, p < 0.001), infectious (OR 1.94, p < 0.001), pressure-related (OR 2.55, p < 0.001), respiratory (OR 2.45, p < 0.001), and delirium (OR 3.11, p < 0.001). When accounting for these predictors, undergoing surgery significantly increased odds of developing one or more of these complications across all categories (p < 0.001 in all categories).

Conclusion : Cervical SCI significantly increases the risk of complications. Higher CCI scores are also strongly associated with increased odds of complications in multiple domains. Surgical interventions can increase the odds of developing these non-surgical complications. These findings emphasize the importance of assessing comorbidities and surgical risk management in SCI patients to mitigate complications.