Protect the neck: Devastating outcomes of cervical spine fractures in the elderly.

Autor: Mormol J; Division of Acute Care Surgery, Corewell Health- West Butterworth Hospital, MI, USA. Electronic address: jeremymormol@gmail.com., Krech L; Division of Acute Care Surgery, Corewell Health- West Butterworth Hospital, MI, USA., Pounders S; Division of Acute Care Surgery, Corewell Health- West Butterworth Hospital, MI, USA., Fisk C; Division of Acute Care Surgery, Corewell Health- West Butterworth Hospital, MI, USA., Chapman A; Division of Acute Care Surgery, Corewell Health- West Butterworth Hospital, MI, USA., Karek M; Division of Acute Care Surgery, Corewell Health- West Butterworth Hospital, MI, USA., Hing KK; Division of Acute Care Surgery, Corewell Health- West Butterworth Hospital, MI, USA.
Jazyk: angličtina
Zdroj: American journal of surgery [Am J Surg] 2024 Apr; Vol. 230, pp. 35-38. Date of Electronic Publication: 2023 Dec 03.
DOI: 10.1016/j.amjsurg.2023.11.034
Abstrakt: Background: Cervical spine fractures are associated with high mortality in elderly patients. This study aims to identify patient-related and in-hospital factors contributing to this mortality.
Methods: A 3-year retrospective study of 235 patients aged 65+ presenting with cervical spine fractures was performed. Age cohorts were 65-74, 75-84, and 85+ years. Mortality was measured at 30, 90, 180 and 365-days post-discharge.
Results: Mortality was 11 ​%, 15 ​%, 19 ​%, and 22 ​% at 30-, 90-, 180- and 365-days respectively. Surgery and fracture pattern was not associated with mortality (p ​= ​0.37; p ​= ​0.28). Charlson Comorbidity Index (p ​< ​0.001; hazard ratio [HR] ​= ​1.3), functional dependency (p ​< ​0.001; HR ​= ​2.5) and delirium (p ​< ​0.001; HR ​= ​8.9) were associated with mortality between 0 and 365 days post-discharge.
Conclusions: Mortality in cervical spine fractures is associated with CCI and delirium, but not associated with operative management or fracture pattern. This suggests the need for careful consideration in patient selection for cervical spine procedures and aggressive inpatient delirium management.
Competing Interests: Declaration of competing interest The following study has been seen and approved by all authors. The current study has not previously been published nor presented in any setting. Artificial Intelligence was not used in the data collection, analysis or writing of this study. There are no financial disclosures to report on behalf of any of the listed authors.
(Copyright © 2023 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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