Abstract:Objective: To evaluate the risk factors for traumatic brain injury (TBI) combined with traumatic cervical spinal cord injury (TCSCI) in patients with multiple traumas based on emergency CT scans, and their impact on prognosis. Methods: A retrospective analysis was conducted on the data of 218 patients with multiple traumas who were admitted to the emergency department of the First Affiliated Hospital of Nanjing Medical University from January 2020 to December 2022 and were not excluded for TCSCI. Based on the cervical MRI results after admission, the presence of TCSCI was determined, and patients were divided into TCSCI and non-TCSCI groups. Multivariate logistic regression analysis was used to screen for independent risk factors, construct a receiver operating characteristic (ROC) curve prediction model, and perform internal validation. Results: Sixty-nine patients (31.7%) had concurrent TCSCI. Multivariate logistic regression analysis showed that higher head abbreviated injury scale (hAIS) scores (OR=1.552, 95% CI: 1.101-2.188), sub-axial injury classification (SLIC) scores (OR=1.235, 95% CI: 1.006-1.517), and paraplegia symptoms (OR=3.810, 95% CI: 1.115-13.020) were independent risk factors for TCSCI. The area under the ROC curve of the prediction model was 0.9 (95% CI: 0.859-0.941). The model's performance was evaluated using the Hosmer-Lemeshow test, indicating good discrimination and calibration of the prediction model. Conclusion: hAIS, SLIC scores, and paraplegia symptoms are independent risk factors for TCSCI in patients with multiple traumas. For patients with multiple traumas who are not excluded for TCSCI, emergency CT scanning and evaluation of hAIS, SLIC scores, and paraplegia symptoms may effectively screen for high-risk TCSCI patients.