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Gastrointestinal Tract Complications After Acute Spine Injury
Jon S. Matsumura, MD;
Jay B. Prystowsky, MD;
Michael A. Bresticker, MD;
Paul R. Meyer, Jr, MD;
Raymond J. Joehl, MD;
David L. Nahrwold, MD
Arch Surg. 1995;130(7):751-753.
Abstract
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Objectives
To determine the incidence, risk factors, and mortality rate of gastrointestinal complications in patients with acute spine injury and to derive methods by which mortality can be reduced.
Design
Case series.
Setting
Regional tertiary care center.
Patients
Consecutive sample of 1952 patients with acute spine injury with complete medical records who were admitted from 1981 through 1990.
Main Outcome Measures
Gastrointestinal tract complications, age, sex, time from injury to admission, cause of injury, level of spine injury, neurologic deficit, head injury, injury to other organ systems, incidence of surgical intervention for spine injury, length of hospital stay, and mortality rate.
Results
The incidence of gastrointestinal complications was 1.9%. Gastrointestinal hemorrhage was the most frequent complication. Risk factors for gastrointestinal complications were increasing age (P<.02), male sex (P<.01), injury to other organ systems (P<.02), head injury (P<.02), cervical spine injury (P<.02), and neurologic deficit (P<.005). The mortality rate was 19% in patients with gastrointestinal complications, significantly greater (P<.005) than the 2.9% rate in patients without gastrointestinal complications.
Conclusions
Gastrointestinal complications after acute spine injury are uncommon but frequently lethal. Prophylaxis against hemorrhage and earlier diagnosis and surgical intervention are recommended.
(Arch Surg. 1995;130:751-753)
Author Affiliations
From the Departments of Surgery (Drs Matsumura, Prystowsky, Bresticker, Joehl, and Nahrwold) and Orthopaedic Surgery (Dr Meyer), Northwestern University Medical School, Chicago, Ill.
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