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Multicenter Study
. 2010 Mar;92(3):567-74.
doi: 10.2106/JBJS.I.00003.

Mortality in elderly patients after cervical spine fractures

Mitchel B Harris  1 , William M Reichmann, Christopher M Bono, Kim Bouchard, Kelly L Corbett, Natalie Warholic, Josef B Simon, Andrew J Schoenfeld, Lawrence Maciolek, Paul Corsello, Elena Losina, Jeffrey N Katz
Affiliations
Multicenter Study

Mortality in elderly patients after cervical spine fractures

Mitchel B Harris et al. J Bone Joint Surg Am. 2010 Mar.

Abstract

Background: Despite an increased risk of cervical spine fractures in older patients, little is known about the mortality associated with these fractures and there is no consensus on the optimal treatment. The purposes of this study were to determine the three-month and one-year mortality associated with cervical spine fractures in patients sixty-five years of age or older and to evaluate potential factors that may influence mortality.

Methods: We performed a retrospective review of all cervical spine fractures in patients sixty-five years of age or older from 1991 to 2006 at two institutions. Information regarding age, sex, race, treatment type, neurological involvement, injury mechanism, comorbidity, and mortality were collected. Overall risk of mortality and mortality stratified by the above factors were calculated at three months and one year. Cox proportional-hazard regression was performed to identify independent correlates of mortality.

Results: Six hundred and forty patients were included in our analysis. The mean age was eighty years (range, sixty-five to 101 years). Two hundred and ninety-four patients (46%) were male, and 116 (18%) were nonwhite. The risk of mortality was 19% at three months and 28% at one year. The effect of treatment on mortality varied with age at three months (p for interaction = 0.03) but not at one year (p for interaction = 0.08), with operative treatment being associated with less mortality for those between the ages of sixty-five and seventy-four years. A higher Charlson comorbidity score, male sex, and neurological involvement were all associated with increased risk of mortality.

Conclusions: Operative treatment of cervical spine fractures is associated with a lower mortality rate at three months but not at one year postoperatively for patients between sixty-five and seventy-four years old at the time of fracture.

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Figures

Fig. 1
Fig. 1
Algorithm for identifying eligible study patients.
Fig. 2-A Fig. 2-B
Fig. 2-A Fig. 2-B
Three-month mortality (Fig. 2-A) and one-year mortality (Fig. 2-B) stratified by treatment (operative compared with nonoperative) and patient age.
Fig. 2-A Fig. 2-B
Fig. 2-A Fig. 2-B
Three-month mortality (Fig. 2-A) and one-year mortality (Fig. 2-B) stratified by treatment (operative compared with nonoperative) and patient age.
See this image and copyright information in PMC

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References

    1. Day JC. Population projections of the United States by age, sex, race and Hispanic origin: 1993 to 2050. US Bureau of the Census, Current Population Reports, Series P25-1104 Washington, DC: Government Printing Office; 1993
    1. Centers for Disease Control and Prevention (CDC) Incidence and costs to Medicare of fractures among Medicare beneficiaries aged > or = 65 years—United States, July 1991-June 1992. MMWR Morb Mortal Wkly Rep. 1996;45:877-83 - PubMed
    1. Kuhne CA, Ruchholtz S, Kaiser GM, Nast-Kolb D. Working Group on Multiple Trauma of the German Society of Trauma. Mortality in severely injured elderly trauma patients—when does age become a risk factor? World J Surg. 2005;29:1476-82 - PubMed
    1. Smith DP, Enderson BL, Maull KI. Trauma in the elderly: determinants of outcome. South Med J. 1990;83:171-7 - PubMed
    1. Jensen JS, Tøndevold E. Mortality after hip fractures. Acta Orthop Scand. 1979;50:161-7 - PubMed

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