Spine Immobilization May Do More Harm Than Good

Study finds odds of mortality higher in patients with penetrating trauma

THURSDAY, Jan. 14 (HealthDay News) -- The odds of mortality for patients with penetrating trauma are doubled by the use of spine immobilization before transportation to hospital, according to a study in the January issue of the Journal of Trauma: Injury, Infection, and Critical Care.

Elliott R. Haut, M.D., of the Johns Hopkins University School of Medicine in Baltimore, and colleagues analyzed data on 45,284 penetrating trauma patients, of whom 4.3 percent underwent spine immobilization.

There was an overall mortality rate of 8.1 percent, but mortality was 14.7 percent for the spine-immobilized group versus 7.2 percent for the non-immobilized patients, the researchers discovered. Number needed to treat showed that 1,032 patients would have to have their spines immobilized for one patient to benefit, whereas only 66 would need to undergo the procedure for one patient to be harmed, the investigators found.

"The risks associated with prehospital spine immobilization outweigh the potential benefits in victims of penetrating trauma," the authors write. "Given these results, we support the current recommendations of prehospital trauma life support, which suggest that the practice of prehospital providers immobilizing all patients with penetrating trauma be discontinued in favor of a more selective approach. Our data suggest that, even with providers' best intentions, some patients may be harmed by prehospital spinal immobilization."

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