Is Early Surgery Tied To Increased Mortality In Polytraumatized Patients?
For polytraumatized patients, surgery for thoracic spine trauma within 72 hours of trauma is associated with increased mortality.
HealthDay News -- For polytraumatized patients, surgery for thoracic spine trauma within 72 hours of trauma is associated with increased mortality, according to a study published in The Spine Journal.
Markus R. Konieczny, MD, from the University Hospital Bergmannsheil in Bochum, Germany, and colleagues conducted a prospective study to validate retrospective data on the effect of timing of surgery on outcomes of polytraumatized patients with severe lesions of the thoracic spine. Thirty-eight multiple-injured patients with unstable fractures of vertebral column from level Th1 to L1 were enrolled. Twenty-two patients underwent early surgery (≤72 hours post trauma), while 16 received late surgery (≥72 hours post trauma).
The researchers found that the mortality rate was significantly higher for patients who received early versus late surgery. Mortality was 67% among patients with an initial hemoglobin (Hb) of less than 10 mg/dL and 75% for those who had an Hb less than 10 mg/dL and received a thoracic drain.
"Although some reports indicate advantages for early surgery for thoracic spine trauma in the polytraumatized patient, careful patient selection should be used," the authors wrote. "Based on the results of this prospective study, early surgery for thoracic spine trauma in patients with concomitant severe thoracic trauma and low initial Hb levels may pose a risk for poor clinical outcomes."
1. Konieczny M, et al. Spine J. 2015; doi: http://dx.doi.org/10.1016/j.spinee.2013.07.469.