Cervical spinal cord injury associated with near-drowning does not increase pneumonia risk or mortality

Thomas Butler, Susanna Shin, Jay Collins, Rebecca C. Britt, Scott F. Reed, Leonard J. Weireter, L. D. Britt

Research output: Contribution to journalArticle

Abstract

Body surfing accidents (BSA) can cause cervical spinal cord injuries (CSCIs) that are associated with near-drowning (ND). The submersion injury from a ND can result in aspiration and pre-dispose to pulmonary complications.We predicted a worse outcome (particularly the development of pneumonia) in patients with CSCIs associated with ND. A retrospective review was performed of patients who were treated at Eastern Virginia Medical School for a CSCI resulting from a blunt mechanism. Data collected included basic demographic data, data regarding injury and in-hospital outcomes, and discharge data, including discharge disposition. Statistics were performed using χ 2 and Student t test. In 2003 to 2008, 141 patients were treated for CSCIs with inclusion criteria. Thirty patients (21%) had an associated ND (BSA) and 111 patients (79%) did not (BLT). The cohorts were similar in mean age (BSA, 45 years; BLT, 50 years; P = 0.16) and male gender distribution (BSA, 93%; BLT, 79%; P = 0.13). The cohorts were similar in injury severity using Injury Severity Score (BSA, 22; BLT, 24; P = 0.65). The cohorts were similar in rates of developing pneumonia (BSA, 3%; BLT, 12%; P = 0.31). The rate of infection was significantly higher in the cohort without an associated near-drowning (BSA, 10%; BLT, 32%; P = 0.033). The mean intensive care unit stay (BSA, 3.5 days; BLT, 11.3 days; P = 0.057) and the rate of mortality were similar (BSA, 10%; BLT, 10% P = 0.99). Those patients with an associated ND had a shorter hospital stay (BSA, 5.7 days; BLT, 22.2 days; P = 0.007) and a better chance of being discharged home (BSA, 57%; BLT, 27%; P = 0.004). CSCIs after a BSA do better than their counterparts without an associated ND. CSCIs associated with ND appear to be isolated injuries with minimal pulmonary involvement despite submersion injuries.

Original languageEnglish (US)
Pages (from-to)426-429
Number of pages4
JournalAmerican Surgeon
Volume77
Issue number4
StatePublished - Apr 2011
Externally publishedYes

Fingerprint

Near Drowning
Spinal Cord Injuries
Accidents
Pneumonia
Mortality
Wounds and Injuries
Immersion
Cervical Cord
Lung
Injury Severity Score
Medical Schools

ASJC Scopus subject areas

  • Surgery

Cite this

Butler, T., Shin, S., Collins, J., Britt, R. C., Reed, S. F., Weireter, L. J., & Britt, L. D. (2011). Cervical spinal cord injury associated with near-drowning does not increase pneumonia risk or mortality. American Surgeon, 77(4), 426-429.

Cervical spinal cord injury associated with near-drowning does not increase pneumonia risk or mortality. / Butler, Thomas; Shin, Susanna; Collins, Jay; Britt, Rebecca C.; Reed, Scott F.; Weireter, Leonard J.; Britt, L. D.

In: American Surgeon, Vol. 77, No. 4, 04.2011, p. 426-429.

Research output: Contribution to journalArticle

Butler, T, Shin, S, Collins, J, Britt, RC, Reed, SF, Weireter, LJ & Britt, LD 2011, 'Cervical spinal cord injury associated with near-drowning does not increase pneumonia risk or mortality', American Surgeon, vol. 77, no. 4, pp. 426-429.
Butler T, Shin S, Collins J, Britt RC, Reed SF, Weireter LJ et al. Cervical spinal cord injury associated with near-drowning does not increase pneumonia risk or mortality. American Surgeon. 2011 Apr;77(4):426-429.
Butler, Thomas ; Shin, Susanna ; Collins, Jay ; Britt, Rebecca C. ; Reed, Scott F. ; Weireter, Leonard J. ; Britt, L. D. / Cervical spinal cord injury associated with near-drowning does not increase pneumonia risk or mortality. In: American Surgeon. 2011 ; Vol. 77, No. 4. pp. 426-429.
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abstract = "Body surfing accidents (BSA) can cause cervical spinal cord injuries (CSCIs) that are associated with near-drowning (ND). The submersion injury from a ND can result in aspiration and pre-dispose to pulmonary complications.We predicted a worse outcome (particularly the development of pneumonia) in patients with CSCIs associated with ND. A retrospective review was performed of patients who were treated at Eastern Virginia Medical School for a CSCI resulting from a blunt mechanism. Data collected included basic demographic data, data regarding injury and in-hospital outcomes, and discharge data, including discharge disposition. Statistics were performed using χ 2 and Student t test. In 2003 to 2008, 141 patients were treated for CSCIs with inclusion criteria. Thirty patients (21{\%}) had an associated ND (BSA) and 111 patients (79{\%}) did not (BLT). The cohorts were similar in mean age (BSA, 45 years; BLT, 50 years; P = 0.16) and male gender distribution (BSA, 93{\%}; BLT, 79{\%}; P = 0.13). The cohorts were similar in injury severity using Injury Severity Score (BSA, 22; BLT, 24; P = 0.65). The cohorts were similar in rates of developing pneumonia (BSA, 3{\%}; BLT, 12{\%}; P = 0.31). The rate of infection was significantly higher in the cohort without an associated near-drowning (BSA, 10{\%}; BLT, 32{\%}; P = 0.033). The mean intensive care unit stay (BSA, 3.5 days; BLT, 11.3 days; P = 0.057) and the rate of mortality were similar (BSA, 10{\%}; BLT, 10{\%} P = 0.99). Those patients with an associated ND had a shorter hospital stay (BSA, 5.7 days; BLT, 22.2 days; P = 0.007) and a better chance of being discharged home (BSA, 57{\%}; BLT, 27{\%}; P = 0.004). CSCIs after a BSA do better than their counterparts without an associated ND. CSCIs associated with ND appear to be isolated injuries with minimal pulmonary involvement despite submersion injuries.",
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