The Number of Organ System Injuries is a Predictor of Intrahospital Mortality in Complete Cervical Spinal Cord Injury.

Abstract Objectives The objective is to determine the extent to which polytrauma significantly impacts intrahospital mortality among patients with complete cervical SCI and to assess whether an organ system-based approach would be appropriate as a mortality predictor as compared to conventional standards to help guide prognosis and management. Methods We retrospectively reviewed patient medical records and assessed the type of associated trauma at presentation. We then reviewed its correlation with mortality in patients who were admitted at our institution between 2012 and 2021. Types of associated trauma were classified under the following: traumatic brain injury, abdominal injury, thoracic injury, orthopedic injury, craniofacial injury, genitourinary injury, and vascular injury. Results Thirty patients with complete cSCIs were identified. Increased organ system-based polytrauma had a statistically significant increase in intrahospital mortality (p=0.01). Using the logistic regression model, for each additional gain in organ system-based trauma, patients had a 2.455 odds ratio of mortality (p=0.03, 95% confidence interval 1.171-6.348). Zero other organ system injuries in the setting of cSCI provided a predictive mortality probability of 6.6%. One organ system-based trauma provided a 14.8% intrahospital mortality probability, two traumas provided a 29.9% mortality probability, three traumas provided a 51.1% mortality probability, and four other organ-system traumas provided a 72.0% mortality probability. The predictive prognostic accuracy of using number of organ system-based trauma to predict mortality probability was quantified at AUC=0.8264 (95% CI 0.6729-0.9799, p=0.01). Conclusions Our research shows that increased number of organ system injuries is associated with greater intrahospital mortality in polytrauma patients with complete cSCI.