12 ANNALS OF EMERGENCY MEDICINE 38:1 JULY 2001 BRIEF REPORT Douglas W. Lowery, MD * Marlena M. Wald, MPH * Brian J. Browne, MD ‡ Stefan Tigges, MD § Jerome R. Hoffman, MA, MD II William R. Mower, MD, PhD II For the NEXUS Group From the Department of Emergency Medicine, Emory University School of Medicine, Atlanta, GA * ; the Depart- ment of Emergency Medicine, Univer- sity of Maryland School of Medicine, Baltimore, MD ‡ ; the Department of Radiology, Emory University School of Medicine, Atlanta, GA § ; UCLA Emergency Medicine Center and Department of Medicine, UCLA School of Medicine, Los Angeles, CA. II Author contributions are provided at the end of this article. Received for publication March 6, 2001. Revision received March 22, 2001. Accepted for publication March 26, 2001. Supported by grant No. R01 HS08239 from the Agency for Healthcare Research and Quality, formerly the Agency for Health Care Policy and Research. Address for reprints: Douglas W. Lowery, MD, Emergency Department, Emory University Hospital, 1364 Clifton Road NE, B-176, Atlanta, GA 30322; 404-712-0448, fax 404-712-4561; E-mail DLOWERY@EMORY.EDU. Copyright © 2001 by the American College of Emergency Physicians. 0196-0644/2001/$35.00 + 0 47/1/116149 doi:10.1067/mem.2001.116149 See related articles, p. 1, p. 8, p. 17, and p. 22. Study objective: We sought to characterize demographics and injury patterns among patients undergoing emergency depart- ment cervical spine radiography for blunt traumatic injury. Methods: All patients with blunt trauma undergoing cervical spine radiography at 21 centers were enrolled in this prospec- tive, observational study. Patients’ date of birth, age, sex, and ethnicity were noted before cervical spine radiography. Results: Demographic factors associated with cervical spine injury, present in 818 of 33,922 patients, included the following: age of 65 years or older (relative risk [RR] 2.09; 95% confidence interval [CI] 1.77 to 2.59); “other” ethnicity (RR 1.79, 95% CI 1.46 to 2.19); male sex (RR 1.72, 95% CI 1.48 to 2.00); and white ethnicity (RR 1.50, 95% CI 1.31 to 1.72). Hispanic ethnic- ity (RR 0.64, 95% CI 0.51 to 0.79), female sex (RR 0.58, 95% CI 0.50 to 0.67), black ethnicity (RR 0.55, 95% CI 0.45 to 0.66), and age of less than 18 years (RR 0.39, 95% CI 0.27 to 0.55) were associated with reduced risk of cervical spine injury. Conclusion: Among patients undergoing ED cervical spine radiography, cervical spine injury is more common among the elderly, male subjects, and patients of white or “other” ethnicity. Because cervical spine injury occurs in patients in all demo- graphic categories, however, this information cannot be used to select individual patients who should or should not undergo imaging. [Lowery DW, Wald MM, Browne BJ, Tigges S, Hoffman JR, Mower WR, for the NEXUS Group. Epidemiology of cervical spine injury victims. Ann Emerg Med. July 2001;38:12-16.] Epidemiology of Cervical Spine Injury Victims