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Predicting early complications in patients with spinal gunshot wounds: A multicenter study

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dc.contributor.authorRicciardi, Guillermo
dc.contributor.authorCabrera, Juan
dc.contributor.authorMartínez, Oscar
dc.contributor.authorMatta, Javier
dc.contributor.authorVilchis, Hugo
dc.contributor.authorPerez, Jeasson
dc.contributor.authorCarazzo, Charles
dc.contributor.authorDittmar, Michael
dc.contributor.authorYurac, Ratko
dc.contributor.authorAO Spine Latin America Trauma Study Group
dc.date.accessioned2024-12-26T15:01:06Z
dc.date.available2024-12-26T15:01:06Z
dc.date.issued2024
dc.description.abstractIntroduction: There is a wide variation in the clinical presentation of spinal gunshot wounds ranging from isolated minor stable fractures to extremely severe injuries with catastrophic neurological damage. Research question: we aim to analyze the risk factors for early complications and impact of surgical treatment in patients with spinal gunshot wounds. Material and methods: This is a multicentre retrospective case-control study to compare patients with spinal gunshot wounds who had early complications with those who did not. The following matching criteria were used: sex (1:1), injury level (1:1) and age (±5 years). Univariate and multivariate analyses were performed using logistic regression. Results: Results: Among 387 patients, 36.9 % registered early complications, being persistent pain (n = 32; 15 %), sepsis/septic shock (n = 28; 13 %), pneumonia (n = 27; 13 %) and neurogenic bladder (n = 27; 12 %) the most frequently reported. After case-control matched analysis, we obtained 133 patients who suffered early complications (cases) and 133 patients who did not as control group, not differing significantly in sex (p = 1000), age (p = 0,535) and injury level (p = 1000), while the 35 % of complications group required surgical treatment versus 15 % of the non-complication group (p < 0.001). On multivariable analysis, significant predictors of complications were surgical treatment for spinal injury (OR = 3.50, 95 % CI = 1.68-7.30), dirty wound (3.32, 1.50-7.34), GCS ≤8 (3.56, 1.17-10.79), hemodynamic instability (2.29, 1.07-4.88), and multiple bullets (1.97, 1.05-3.67). Discussion and conclusion: Spinal gunshot wounds are associated with a high risk of early complications, especially when spinal surgery is required, and among patients with dirty wound, low level of consciousness, hemodynamic instability, and multiple bullets.
dc.description.versionVersión Aceptada
dc.identifier.citationRicciardi GA, Cabrera JP, Martínez O, Matta J, Vilchis H, Perez Ríos JJ, Carazzo CA, Dittmar M, Yurac R; AO Spine Latin America Trauma Study Group. Predicting early complications in patients with spinal gunshot wounds: A multicenter study. Brain Spine. 2024 Feb 28;4:102766. doi: 10.1016/j.bas.2024.102766.
dc.identifier.doihttps://doi.org/10.1016/j.bas.2024.102766
dc.identifier.urihttps://hdl.handle.net/11447/9529
dc.language.isoen
dc.subjectFirearms
dc.subjectFracture fixation
dc.subjectGunshot wounds
dc.subjectPostoperative complications
dc.subjectRisk factors
dc.subjectSurgery
dc.titlePredicting early complications in patients with spinal gunshot wounds: A multicenter study
dc.typeArticle
dcterms.accessRightsAcceso Abierto
dcterms.sourceBrain & spine
dspace.entity.typePublication
relation.isAuthorOfPublication631830b2-9e94-4f76-bf44-70d266274dbc
relation.isAuthorOfPublication.latestForDiscovery631830b2-9e94-4f76-bf44-70d266274dbc

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