Varma et al identified risk factors for early mortality in a patient with traumatic spinal cord injury. These can help to identify a patient who may benefit from more aggressive management. The authors are from the Medical University of South Carolina.


Early mortality was defined as death during the initial admission (in the acute care setting prior to transfer to an extended care facility or discharge).


Predictors of early mortality:

(1) age > 20 years (Figure 1 indicates increasing risk after age 30)

(2) male gender

(3) ISS >= 15 (severe systemic injuries)

(4) 1 or more significant comorbidities

(5) poor neurological status

(6) traumatic brain injury (TBI)

(7) treatment at a major trauma center (Level I or II)



• The authors referred to Level I or II trauma centers as level 1, and Level III+ trauma centers as level 2.

• A major trauma center should be associated with better trauma care. The increased risk associated with major trauma center care may be related to the fact that serious trauma cases are routed there.


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