BACKGROUND CONTEXT: Only Level 3 evidence exists for the diagnosis and treatment of @entity3029 ( @entity3029 ) with few studies examining mortality, neurologic improvement, and @entity1 -reported outcomes (PROs). PURPOSE: First, the aim was to determine: the incidence of @entity3029 , 90-day surgical morbidity and mortality after @entity3029 , @entity1 factors that may be associated with delayed or missed diagnosis, and factors that were associated with mortality and neurologic improvement after @entity3029 . Secondly, the aim was to quantify the @entity158 , disability, and quality of life experienced by @entity1 surviving @entity3029 . STUDY DESIGN/SETTING: This was a retrospective cohort study. @entity1 SAMPLE: A total of 5,337 consecutive spine computed tomography traumagrams from 1997 to 2012 were included. OUTCOME MEASURES: Mortality, neurologic improvement, complications, EuroQol five dimensions (EQ-5D), @entity717 ( @entity717 ), Numeric Rating Scale (NRS)-neck, NRS-arm, and return-to-work were the outcome measures. METHODS: @entity1 were considered to have @entity3029 if they met one of the following radiographic criteria: basion-dens interval greater than 10 mm; basion-axial interval: anterior displacement greater than 12 mm or posterior displacement greater than 4 mm between the basion and posterior C2 line; and condyle to C1 interval greater than 1.4 mm. Linear regression analysis was performed to identify factors associated with 90-day mortality, neurologic improvement, and missed diagnosis. @entity1 -reported outcomes were assessed via phone interview. RESULTS: Thirty-one @entity1 met radiographic criteria for @entity3029 ; an incidence of 0.6% over 15 years. Twenty-one (68%) @entity1 were treated with occipital cervical fusion. At 90 days postoperatively, there were no new @entity51 or reoperations. Eight (26%) @entity1 died within 90 days. All @entity1 who died had no documented @entity3029 diagnosis and were not treated surgically. Missed @entity3029 diagnosis was the strongest predictor of mortality. Younger age, lower Glasgow @entity772 Score, lower Injury Severity Score (ISS) score, and worse initial American @entity3510 Association (ASIA) score were significantly associated with greater neurologic improvement. Higher ISS score and better ASIA score were significantly associated with missed @entity3029 diagnosis. The average PROs metrics at time of telephone follow-up were as follows: EQ-5D=0.73  0.19, @entity717 =30.89  18.57, NRS-neck=2.33  2.21, NRS-arm=2.00  2.54. Of the @entity1 with follow-up data, four were employed full-time, and five were receiving disability. CONCLUSIONS: Our work suggests that failure to diagnose @entity3029 is a powerful predictor of mortality. Higher ISS scores and better neurologic presentation were significantly associated with missed diagnosis. Craniocervical arthrodesis preserved neurologic function with low complication rate and unexpectedly high PROs and return-to-work. These results must be carefully interpreted because it is unclear whether missed @entity3029 diagnosis accompanies another @entity204 (eg, @entity131 ) or if failure to treat @entity3029 contributes to mortality in a multifactorial manner.

Traumatic atlantooccipital dislocation: comprehensive assessment of mortality, neurologic improvement, and XXXX -reported outcomes at a Level 1 trauma center over 15 years.

@entity1 :: ('9606', 'Species') :: ['Patients', 'patients', 'patient', 'Patient', 'PATIENT'] @entity3510 :: ('MESH:D013124', 'Disease') :: ['Spinal Injury'] @entity131 :: ('MESH:D001930', 'Disease') :: ['traumatic brain injury'] @entity772 :: ('MESH:D003128', 'Disease') :: ['Coma'] @entity51 :: ('MESH:D009461', 'Disease') :: ['neurologic deficits'] @entity158 :: ('MESH:D010146', 'Disease') :: ['pain'] @entity717 :: ('MESH:D009069', 'Disease') :: ['Neck Disability Index', 'NDI'] @entity204 :: ('MESH:D003643', 'Disease') :: ['death-causing injury'] @entity3029 :: ('MESH:D004204', 'Disease') :: ['AOD', 'atlantooccipital dislocation']
@entity1 :: (9606,Species) :: ['patient']
