GASTROINTESTINAL-TRACT COMPLICATIONS AFTER ACUTE SPINE INJURY

Objectives: To determine the incidence, risk factors, and mortality ra te of gastrointestinal complications in patients with acute spine inju ry and to derive methods by which mortality can be reduced. Design: Ca se series. Setting: Regional tertiary care center. Patients: Consecuti ve sample of 1952 patients with acute spine injury with complete medic al records who were admitted from 1981 through 1990. Main Outcome Meas ures: Gastrointestinal tract complications, age, sex, time from injury to admission, cause of injury, level of spine injury, neurologic defi cit, 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. Ri sk factors for gastrointestinal complications were increasing age (P<. 02), male sex (P<.01), injury to other organ systems (P<.02), head inj ury (P<.02), cervical spine injury (P<.02), and neurologic deficit (P< .005). The mortality rate was 19% in patients with gastrointestinal co mplications, significantly greater (P<.005) than the 2.9% rate in pati ents without gastrointestinal complications. Conclusions: Gastrointest inal complications after acute spine injury are uncommon but frequentl y lethal. Prophylaxis against hemorrhage and earlier diagnosis and sur gical intervention are recommended.