Risk Factors for CSI in Children
| Risk Factors . | Bivariable RR (CI) . | PECARN Modela OR (CI) . | De Novo Modelb OR (CI) . |
|---|---|---|---|
| Mechanism of injury or biomechanics | |||
| High-risk MVCc | 1.57 (0.64–3.83) | 1.58 (0.63–3.97) | — |
| Diving | 13.69 (5.64–33.27) | 17.60 (5.60–55.32) | 9.16 (2.41–34.83) |
| Axial load | 3.18 (1.74–5.81) | — | 2.51 (1.22–5.16) |
| Clothesliningd | 3.28 (1.07–10.08) | — | — |
| Patient history | |||
| Predisposing conditions | 1.99 (0.29–13.80) | 2.02 (0.27–15.10) | — |
| Loss of consciousness | 2.07 (1.25–3.43) | — | — |
| Neck pain | 1.64 (1.04–2.57) | 1.65 (1.04–2.62) | 2.87 (1.50–5.48) |
| Inability to move neck | 3.61 (1.98–6.60) | 3.77 (2.00–7.12) | 3.51 (1.72–7.17) |
| Paresthesias | 0.56 (0.14–2.25) | — | — |
| Numbness | 0.38 (0.05–2.74) | — | — |
| Weakness | 0.48 (0.07–3.41) | — | — |
| Physical examination | |||
| Altered mental status | 5.37 (3.42–8.44) | 5.67 (3.54–9.09) | 2.90 (1.37–6.12) |
| Intubated | 11.35 (7.02–18.25) | — | 10.71 (4.43–25.91) |
| Signs of substantial head injury other than altered mental status | 0.40 (0.10–1.61) | — | — |
| Signs of basilar skull fracture | 5.52 (2.32–13.13) | — | — |
| Posterior midline tenderness to palpation | 1.47 (0.94–2.32) | — | — |
| Limited neck range of motion | 1.82 (0.89–3.76) | 1.85 (0.88–3.90) | — |
| Substantial torso injury | 2.54 (1.24–5.22) | 2.61 (1.24–5.53) | — |
| Substantial thoracic injury | 5.74 (2.42–13.63) | — | — |
| Respiratory distress | 13.69 (5.64–33.28) | — | 5.84 (1.56–21.88) |
| Decreased oxygen saturation | 15.67 (5.81–42.27) | — | — |
| Substantial abdominal injury | 1.86 (0.69–5.01) | — | — |
| Substantial pelvic injury | No estimatee | — | — |
| Thoracic spine tenderness | 1.11 (0.63–1.94) | — | — |
| Lumbar spine tenderness | 0.42 (0.16–1.16) | — | — |
| Sacral spine tenderness | 0.40 (0.06–2.82) | — | — |
| Focal neurologic deficits | 2.55 (1.05–6.20) | 2.62 (1.04–6.63) | — |
| Paresthesias | No estimatee | — | — |
| Decreased sensation | 2.12 (0.53–8.40) | — | — |
| Weakness | 1.67 (0.42–6.66) | — | — |
| Risk Factors . | Bivariable RR (CI) . | PECARN Modela OR (CI) . | De Novo Modelb OR (CI) . |
|---|---|---|---|
| Mechanism of injury or biomechanics | |||
| High-risk MVCc | 1.57 (0.64–3.83) | 1.58 (0.63–3.97) | — |
| Diving | 13.69 (5.64–33.27) | 17.60 (5.60–55.32) | 9.16 (2.41–34.83) |
| Axial load | 3.18 (1.74–5.81) | — | 2.51 (1.22–5.16) |
| Clothesliningd | 3.28 (1.07–10.08) | — | — |
| Patient history | |||
| Predisposing conditions | 1.99 (0.29–13.80) | 2.02 (0.27–15.10) | — |
| Loss of consciousness | 2.07 (1.25–3.43) | — | — |
| Neck pain | 1.64 (1.04–2.57) | 1.65 (1.04–2.62) | 2.87 (1.50–5.48) |
| Inability to move neck | 3.61 (1.98–6.60) | 3.77 (2.00–7.12) | 3.51 (1.72–7.17) |
| Paresthesias | 0.56 (0.14–2.25) | — | — |
| Numbness | 0.38 (0.05–2.74) | — | — |
| Weakness | 0.48 (0.07–3.41) | — | — |
| Physical examination | |||
| Altered mental status | 5.37 (3.42–8.44) | 5.67 (3.54–9.09) | 2.90 (1.37–6.12) |
| Intubated | 11.35 (7.02–18.25) | — | 10.71 (4.43–25.91) |
| Signs of substantial head injury other than altered mental status | 0.40 (0.10–1.61) | — | — |
| Signs of basilar skull fracture | 5.52 (2.32–13.13) | — | — |
| Posterior midline tenderness to palpation | 1.47 (0.94–2.32) | — | — |
| Limited neck range of motion | 1.82 (0.89–3.76) | 1.85 (0.88–3.90) | — |
| Substantial torso injury | 2.54 (1.24–5.22) | 2.61 (1.24–5.53) | — |
| Substantial thoracic injury | 5.74 (2.42–13.63) | — | — |
| Respiratory distress | 13.69 (5.64–33.28) | — | 5.84 (1.56–21.88) |
| Decreased oxygen saturation | 15.67 (5.81–42.27) | — | — |
| Substantial abdominal injury | 1.86 (0.69–5.01) | — | — |
| Substantial pelvic injury | No estimatee | — | — |
| Thoracic spine tenderness | 1.11 (0.63–1.94) | — | — |
| Lumbar spine tenderness | 0.42 (0.16–1.16) | — | — |
| Sacral spine tenderness | 0.40 (0.06–2.82) | — | — |
| Focal neurologic deficits | 2.55 (1.05–6.20) | 2.62 (1.04–6.63) | — |
| Paresthesias | No estimatee | — | — |
| Decreased sensation | 2.12 (0.53–8.40) | — | — |
| Weakness | 1.67 (0.42–6.66) | — | — |
—, not applicable.
Model including only those variables identified in the PECARN retrospective case-control study.
Model created by using stepwise variable selection.
Intrusion, including roof; >12 inches occupant site, >18 inches any site; ejection (partial or complete) from automobile; death in same passenger compartment; vehicle telemetry data consistent with a high-risk crash.
Biomechanical force caused by a rope, cable, or similar item exerting traction on the neck while the body is in forward motion.
No children with CSIs within the cohort had the finding.