Blunt Versus Penetrating Neck Trauma: A Retrospective Cohort Study

• Published in: The Laryngoscope 2021-04, Vol.131 (4), p.E1109-E1116
• Main Authors: Forner, David, Noel, Christopher W., Guttman, Matthew P., Haas, Barbara, Enepekides, Danny, Rigby, Matthew H., Nathens, Avery B., Eskander, Antoine
• Format: Article
• Language: English
• Subjects: Adult; blunt trauma; Cohort analysis; Confidence intervals; Female; Glasgow Coma Scale; Hospital Mortality; Humans; Injuries; Injury Severity Score; Laryngoscopy; Length of Stay - statistics & numerical data; Male; Middle Aged; Mortality; Neck; Neck Injuries - mortality; Neck Injuries - surgery; neck trauma; penetrating trauma; Retrospective Studies; survival; Trauma; trauma, broncho‐esophagology; trauma, laryngology; Wounds, Nonpenetrating - mortality; Wounds, Nonpenetrating - surgery; Wounds, Penetrating - mortality; Wounds, Penetrating - surgery
• ISSN: 0023-852X; 1531-4995
• DOI: 10.1002/lary.29088

Objectives/Hypothesis Despite being common, neck injuries have received relatively little attention for important quality of care metrics. This study sought to determine the association between blunt and penetrating neck injuries on mortality and length of stay, and to identify additional patient and hospital‐level characteristics that impact these outcomes. Study Design Retrospective cohort study utilizing the American College of Surgeons Trauma Quality Improvement Program database. Methods Adult patients (≥18) who sustained traumatic injuries involving the soft tissues of the neck between 2012 and 2016 were eligible. Multiple imputation was used to account for missing data. Logistic regression and negative binomial models were used to analyze 1) in‐hospital mortality and 2) length of stay respectively while adjusting for potential confounders and accounting for clustering at the hospital level. Results In a cohort of 20,285 patients, the crude mortality rate was lower in those sustaining blunt neck injuries compared to penetrating injuries (4.9% vs. 6.0%, P