Characteristics of Cervical Spine Injuries Caused by Industrial Accidents: The Experience of a Single Regional Trauma Center in South Korea

S. Yoon, Hong Bo Sim, I. Lyo, S. Kwon, Min Soo Kim
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Abstract

Objective: This study examined the characteristics of patients with cervical spine injuries caused by industrial accidents and analyzed the factors related to mortality. Methods: In total, 424 patients with cervical spine injuries who visited our hospital from 2016 to 2020 were divided into an industrial accident and non-industrial accident groups. Age, sex, fracture severity, facet injury, high cervical injury, spinal epidural hematoma, spinal cord injury, shock, arrival route, Injury Severity Score (ISS), Glasgow Coma Scale (GCS), mortality, and trauma mechanism were compared between the two groups. Regression analysis was performed to determine the factors affecting mortality. Results: Industrial accident patients significantly differed from the rest of the study population in terms of the sex ratio (male ratio, 95.1% vs. 77.8%; p<0.001), arrival route (direct transport, 61.2% vs. 50.9%; p=0.017), and trauma mechanism (p<0.001). Among the trauma mechanisms, falls had the largest difference between industrial accident patients and all patients (55.3% and 28.1%, respectively). Significant associations with mortality were found for falls (odds ratio [OR], 22.330; p=0.015), ISS (OR, 1.056; p=0.008), GCS <9 (OR, 0.014; p<0.001), and shock (OR, 7.290; p<0.001). Conclusion: Falls were the most frequent trauma mechanism of cervical spine injuries in patients who experienced industrial accidents. The factors significantly correlated with mortality were falls, ISS, GCS <9, and shock.
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工业事故引起颈椎损伤的特点:韩国单一区域创伤中心的经验
目的:探讨工业事故颈椎损伤患者的特点,分析其死亡的相关因素。方法:将2016 - 2020年在我院就诊的424例颈椎损伤患者分为工伤组和非工伤组。比较两组患者的年龄、性别、骨折严重程度、小关节面损伤、高位颈椎损伤、脊髓硬膜外血肿、脊髓损伤、休克、到达途径、损伤严重程度评分(ISS)、格拉斯哥昏迷评分(GCS)、死亡率、创伤机制。采用回归分析确定影响死亡率的因素。结果:工业事故患者在性别比例方面与其他研究人群存在显著差异(男性比例,95.1% vs. 77.8%;P <0.001),到达途径(直达交通,61.2% vs. 50.9%;P =0.017),创伤机制(P <0.001)。工伤事故患者与所有患者的创伤机制中,跌倒的差异最大(分别为55.3%和28.1%)。跌倒与死亡率有显著相关性(优势比[OR], 22.330;p=0.015), ISS (OR, 1.056;p=0.008), GCS <9 (OR, 0.014;p<0.001),休克(OR, 7.290;p < 0.001)。结论:跌倒是工业事故颈椎损伤最常见的外伤机制。与死亡率显著相关的因素是跌倒、ISS、GCS <9和休克。
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