Outcomes of odontoid fractures with associated cardiac arrest: retrospective bi-center case series and systematic literature review.
Cervical injuries
Heart arrest
Resuscitation
Review
Spinal injuries
Journal
Scandinavian journal of trauma, resuscitation and emergency medicine
ISSN: 1757-7241
Titre abrégé: Scand J Trauma Resusc Emerg Med
Pays: England
ID NLM: 101477511
Informations de publication
Date de publication:
29 Oct 2024
29 Oct 2024
Historique:
received:
29
07
2024
accepted:
15
10
2024
medline:
30
10
2024
pubmed:
30
10
2024
entrez:
30
10
2024
Statut:
epublish
Résumé
Odontoid fractures from high-energy trauma are associated with significant morbidity and mortality, including spinal cord injury, neurological damage, and cardiac arrest. The literature on odontoid fractures leading to cardiac arrest is limited to isolated case reports. This study aims to conduct a retrospective bi-center case series and a systematic review of existing literature. We conducted a retrospective bi-center case series on patients with odontoid fractures from high-energy trauma who experienced post-traumatic cardiac arrest with return of spontaneous circulation (ROSC) after CPR from two Level 1 Trauma Centers (2008-2024). The primary outcome was in-hospital mortality; secondary outcomes included epidemiological, pre-hospital, and in-hospital data, and CT and MRI findings. Additionally, we performed a systematic literature review to summarize existing evidence. The study included 25 patients (mean age 71.1 ± 12.3 years, SD; 8 females). The mortality rate was 92% (23 patients). Median downtime before CPR was 5.0 min (IQR: 7.0), with CPR lasting 17.0 min (IQR: 13.0), primarily initiated by professionals (60%). All patients were quadriplegic. Type II Anderson d'Alonzo fractures were most common (88%), with all patients showing myelopathy on MRI. Only three patients (12%) underwent surgical intervention due to favorable prognosis. Our literature review identified seven case reports, with two patients surviving and one achieving full recovery. In this case series, patients experiencing cardiac arrest after odontoid fractures exhibited high mortality rates despite comprehensive management at Level 1 trauma centers. Survivors faced significant and enduring morbidity.
Sections du résumé
BACKGROUND
BACKGROUND
Odontoid fractures from high-energy trauma are associated with significant morbidity and mortality, including spinal cord injury, neurological damage, and cardiac arrest. The literature on odontoid fractures leading to cardiac arrest is limited to isolated case reports. This study aims to conduct a retrospective bi-center case series and a systematic review of existing literature.
METHODS
METHODS
We conducted a retrospective bi-center case series on patients with odontoid fractures from high-energy trauma who experienced post-traumatic cardiac arrest with return of spontaneous circulation (ROSC) after CPR from two Level 1 Trauma Centers (2008-2024). The primary outcome was in-hospital mortality; secondary outcomes included epidemiological, pre-hospital, and in-hospital data, and CT and MRI findings. Additionally, we performed a systematic literature review to summarize existing evidence.
RESULTS
RESULTS
The study included 25 patients (mean age 71.1 ± 12.3 years, SD; 8 females). The mortality rate was 92% (23 patients). Median downtime before CPR was 5.0 min (IQR: 7.0), with CPR lasting 17.0 min (IQR: 13.0), primarily initiated by professionals (60%). All patients were quadriplegic. Type II Anderson d'Alonzo fractures were most common (88%), with all patients showing myelopathy on MRI. Only three patients (12%) underwent surgical intervention due to favorable prognosis. Our literature review identified seven case reports, with two patients surviving and one achieving full recovery.
CONCLUSIONS
CONCLUSIONS
In this case series, patients experiencing cardiac arrest after odontoid fractures exhibited high mortality rates despite comprehensive management at Level 1 trauma centers. Survivors faced significant and enduring morbidity.
Identifiants
pubmed: 39472996
doi: 10.1186/s13049-024-01277-z
pii: 10.1186/s13049-024-01277-z
doi:
Types de publication
Journal Article
Systematic Review
Multicenter Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
105Informations de copyright
© 2024. The Author(s).
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