Journal of Auto-vehicle Safety Association (자동차안전학회지)

Korean Auto-vehicle Safety Association (한국자동차안전학회)
권호 표지
DOI QR코드

DOI QR Code

Parameter Analysis to Predict Cervical Spine Injury on Motor Vehicle Accidents

탑승자 교통사고에서 경추손상 판단을 위한 중증도 요인 분석

  • 이희영 (연세대학교 원주의과대학 응급의학교실) ;
  • 육현 (연세대학교 원주의과대학 응급의학교실) ;
  • 공준석 (연세대학교 원주의과대학 응급의학교실) ;
  • 강찬영 (연세대학교 원주의과대학 응급의학교실) ;
  • 성실 (연세대학교 원주의과대학 응급의학교실) ;
  • 이정훈 (연세대학교 원주의과대학 응급의학교실) ;
  • 김호중 (순천향대학교 부천병원 응급의학과) ;
  • 김상철 (충북대학교병원 응급의학과) ;
  • 추연일 (충북대학교병원 응급의학과) ;
  • 전혁진 (춘해보건대학교 응급구조학과) ;
  • 박종찬 (국립과학수사연구원 교통사고분석과) ;
  • 최지훈 (국립과학수사연구원 교통사고분석과) ;
  • 이강현 (연세대학교 원주의과대학 응급의학교실)
  • Received : 2018.05.25
  • Accepted : 2018.08.21
  • Published : 2018.09.30
Download PDF
⟨ Previous Next ⟩

Abstract

It was a pilot study for developing an algorithm to determine the presence or absence of cervical spine injury by analyzing the severity factor of the patients in motor vehicle occupant accidents. From August 2012 to October 2016, we used the KIDAS database, called as Korean In-Depth Accident Study database, collected from three regional emergency centers. We analyzed the general characteristics with several factors. Moreover, cervical spine injury patients were divided into two groups: Group 1 for from Quebec Task Force (hereinafter 'QTF') grade 0 to 1, and group 2 for from QTF grade 2 to 4. The score was assigned according to the distribution ratio of cervical spine injured patients compared to the total injured patients, and the cut-off value was derived from the total score by summation of the assigned score of each factors. 987 patients (53.0%) had no cervical spine injuries and 874 patients (47.0%) had cervical spine injuries. QTF grade 2 was found in 171 patients (9.2%) with musculoskeletal pain, QTF grade 3 was found in 38 patients (2.0%) with spinal cord injuries, and QTF grade 4 was found in 119 patients (6.4%) with dislocation or fracture, respectively. We selected the statistically significant factors, which could be affected the cervical spine injury, like the collision direction, the seating position, the deformation extent, the vehicle type and the frontal airbag deployment. Total score, summation of the assigned each factors, 10 was presented as a cut-off value to determine the cervical spine injury. In this study, it was meaningful as a pilot study to develop algorithms by selecting limited influence factors and proposing cut-off value to determine cervical spine injury. However, since the number of data samples was too small, additional data collection and influencing factor analysis should be performed to develop a more delicate algorithm.

Keywords

References

  1. 도로교통공단, 2016, "OECD 회원국 교통사고 비교".
  2. TAAS 교통사고 분석 시스템, Available at http://taas.koroad.or.kr. Accessed on 1st April 2017.
  3. Grossman M. D., Reilly P. M., Gillett T., Gillett D., 1999, "National Survey of the Incidence of Cervical Spine Injury and Approach to Cervical Spine Clearance in U.S. Trauma Centers", The Journal of Trauma: Injury, Infection, and Critical Care, Vol. 47, No. 4, pp. 684-691. https://doi.org/10.1097/00005373-199910000-00012
  4. Davis J. W., Phreaner D. L., Hoyt D. B., Mackersie R. C., 1993, "The etiology of missed cervical spine injuries", The Journal of Trauma: Injury, Infection, and Critical Care, Vol. 34, No. 3, pp. 342-346. https://doi.org/10.1097/00005373-199303000-00006
  5. Sanchez B., Waxman K., Jones T., Conner S., Chung R., Becerra S., 2005, "Cervical Spine Clearance in Blunt Trauma: Evaluation of a Computed Tomography-Based Protocol", The Journal of Trauma: Injury, Infection, and Critical Care, Vol. 59, No. 1, pp. 179-184. https://doi.org/10.1097/01.TA.0000171449.94650.81
  6. Hoffman J. R., Wolfson A. B., Todd K., Mower W. R., 1998, "Selective Cervical Spine Radiography in Blunt Trauma: Methodology of the National Emergency X-Radiography Utilization Study (NEXUS)", Annals of Emergency Medicine, Vol. 32, No. 4, pp. 461-469. https://doi.org/10.1016/S0196-0644(98)70176-3
  7. Stiell I. G., Wells G. A., Vandemheen K. L., Clement C. M., Lesiuk H., De Maio V. J., Laupacis A., Schull M., McKnight R. D., Verbeek R., Brison R., Cass D., Dreyer J., Eisenhauer M. A., Greenberg G. H., MacPhail I., Morrison L., Reardon M., Worthington J., 2001, "The Canadian C-spine rule for radiography in alert and stable trauma patients", Journal of the American Medical Association, Vol. 286, No. 15, pp. 1841-1848. https://doi.org/10.1001/jama.286.15.1841
  8. Besman A., Kaban J., Jacobs L., Jacobs L. M., 2003, "False-negative plain cervical spine x-rays in blunt trauma", The American Journal of Surgery, Vol. 69, No. 11, pp. 1010-1014.
  9. Crim J. R., Moore K., Brodke D., 2001, "Clearance of the cervical spine in multitrauma patients: the role of advanced imaging", Seminars in Ultrasound CT and MRI, Vol. 22, No. 4, pp. 283-305.
  10. Hanson J. A., Deliganis A. V., Baxter A. B., Cohen W. A., Linnau K. F., Wilson A. J., Mann F. A., 2002, "Radiologic and clinical spectrum of occipital condyle fractures: retrospective review of 107 consecutive fractures in 95 patients", American Journal of Roentgenology, Vol. 178, No. 5, pp. 1261-1268. https://doi.org/10.2214/ajr.178.5.1781261
  11. Stiell I. G., Clement C. M., Mcknight R. D., Brison R., Schull M. J., Rowe B. H., Worthington J. R., Eisenhauer M. A., Cass D., Greenberg G., MacPhail I., Dreyer J., Lee J. S., Bandiera G., Reardon M., Holroyd B., Lesiuk H., Wells G. A., 2003, "The Canadian C-Spine rule versus the NEXUS low-risk criteria in patients with trauma", The New England Journal of Medicine, Vol. 349, No. 26, pp. 2510-2518. https://doi.org/10.1056/NEJMoa031375
  12. Daffner R. H., 2008, "Cervical radiography for trauma patients: a time-effective technique?", American Journal of Roentgenology, Vol. 175, No. 5, pp. 1309-1311.
  13. Fisher A., Young W. F., 2008, "Is the lateral cervical spine xray obsolete during the initial evaluation of patients with acute trauma?", Surgical Neurology, Vol. 70, No. 1, pp. 53-57. https://doi.org/10.1016/j.surneu.2007.08.011
  14. Kim S. W., Lee J. W., Youn Y. H., 2014, "A study on the construction of the database structure for the Korea In-Depth Accident Study", Transactions of the Korean Society of Automotive Engineers, Vol. 22, No. 2, pp. 29-36. https://doi.org/10.7467/KSAE.2014.22.2.029
  15. Atlas S. J., Deyo R. A., Patrick D. L., Convery K., Keller R. B., Singer D. E., 1996, "The Quebec Task Force classification for spinal disorders and the severity, treatment, and outcomes of sciatica and lumbar spinal stenosis", Spine, Vol. 21, No. 24, pp. 2885-2892. https://doi.org/10.1097/00007632-199612150-00020