Head injury with concurrent cervical spine injury
Dual diagnoses of moderate or severe head injuries occurring concurrently with cervical spine injuries are postulated to have very poor outcomes. These outcomes are unknown in resource-limited settings.
Methods: Patient files with dual diagnoses between 2012 and 2016 at the Kenyatta National Hospital (KNH) were reviewed retrospectively. Clinical and outcome parameters were identified for each case and SPSS version 20 was used for correlation and regression tests.
Results: Eleven patient files were identified; patients’ median age was 34 years. C2 was the modal cervical spine injury level. The most common clinical presentation (63%) was loss of consciousness; 45% of patients had a Glasgow Outcome score ≤1. Using Pearson correlation study, age was significantly positively correlated with outcome: r = 0.751, n = 11, p = 0.008. A significant regression equation was found (F (1, 9) = 11.624, p <0.001) with an adjusted R2 of 0.515 to predict outcome on the Glasgow Outcome Scale based on age.
Conclusion: For patients with dual diagnoses in a resource-limited setting, survival rate is 45%; and older patients have poorer outcomes. Neurosurgeons practising in areas with limited resources should keep this in mind with the hope of attaining better outcomes.
Keywords: Head injury, Dual diagnosis, Cervical spine injury