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Age and Other Risk Factors Influencing Long-Term Mortality in Patients With Traumatic Cervical Spine Fracture
OBJECTIVE: To identify clinical or demographic variables that influence long-term mortality, as well as in-hospital mortality, with a particular focus on the effects of age. SUMMARY AND BACKGROUND DATA: Cervical spine fractures with or without spinal cord injury (SCI) disproportionately impact the e...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
SAGE Publications
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5946346/ https://www.ncbi.nlm.nih.gov/pubmed/29760965 http://dx.doi.org/10.1177/2151459318770882 |
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author | Bank, Matthew Gibbs, Katie Sison, Cristina Kutub, Nawshin Papatheodorou, Angelos Lee, Samuel Stein, Adam Bloom, Ona |
author_facet | Bank, Matthew Gibbs, Katie Sison, Cristina Kutub, Nawshin Papatheodorou, Angelos Lee, Samuel Stein, Adam Bloom, Ona |
author_sort | Bank, Matthew |
collection | PubMed |
description | OBJECTIVE: To identify clinical or demographic variables that influence long-term mortality, as well as in-hospital mortality, with a particular focus on the effects of age. SUMMARY AND BACKGROUND DATA: Cervical spine fractures with or without spinal cord injury (SCI) disproportionately impact the elderly who constitute an increasing percentage of the US population. METHODS: We analyzed data collected for 10 years at a state-designated level I trauma center to identify variables that influenced in-hospital and long-term mortality among elderly patients with traumatic cervical spine fracture with or without SCI. Acute in-hospital mortality was determined from hospital records and long-term mortality within the study period (2003-2013) was determined from the National Death Index. Univariate and multivariate regression analyses were used to identify factors influencing survival. RESULTS: Data from patients (N = 632) with cervical spine fractures were analyzed, the majority (66%) of whom were geriatric (older than age 64). Most patients (62%) had a mild/moderate injury severity score (ISS; median, interquartile range: 6, 5). Patients with SCI had significantly longer lengths of stay (14.1 days), days on a ventilator (3.5 days), and higher ISS (14.9) than patients without SCI (P < .0001 for all). Falls were the leading mechanism of injury for patients older than age 64. Univariate analysis identified that long-term survival decreased significantly for all patients older than age 65 (hazard ratio [HR]: 1.07; P < .0001). Multivariate analysis demonstrated age (HR: 1.08; P < .0001), gender (HR: 1.60; P < .0007), and SCI status (HR: 1.45, P < .02) significantly influenced survival during the study period. CONCLUSION: This study identified age, gender, and SCI status as significant variables for this study population influencing long-term survival among patients with cervical spine fractures. Our results support the growing notion that cervical spine injuries in geriatric patients with trauma may warrant additional research. |
format | Online Article Text |
id | pubmed-5946346 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | SAGE Publications |
record_format | MEDLINE/PubMed |
spelling | pubmed-59463462018-05-14 Age and Other Risk Factors Influencing Long-Term Mortality in Patients With Traumatic Cervical Spine Fracture Bank, Matthew Gibbs, Katie Sison, Cristina Kutub, Nawshin Papatheodorou, Angelos Lee, Samuel Stein, Adam Bloom, Ona Geriatr Orthop Surg Rehabil Original Article OBJECTIVE: To identify clinical or demographic variables that influence long-term mortality, as well as in-hospital mortality, with a particular focus on the effects of age. SUMMARY AND BACKGROUND DATA: Cervical spine fractures with or without spinal cord injury (SCI) disproportionately impact the elderly who constitute an increasing percentage of the US population. METHODS: We analyzed data collected for 10 years at a state-designated level I trauma center to identify variables that influenced in-hospital and long-term mortality among elderly patients with traumatic cervical spine fracture with or without SCI. Acute in-hospital mortality was determined from hospital records and long-term mortality within the study period (2003-2013) was determined from the National Death Index. Univariate and multivariate regression analyses were used to identify factors influencing survival. RESULTS: Data from patients (N = 632) with cervical spine fractures were analyzed, the majority (66%) of whom were geriatric (older than age 64). Most patients (62%) had a mild/moderate injury severity score (ISS; median, interquartile range: 6, 5). Patients with SCI had significantly longer lengths of stay (14.1 days), days on a ventilator (3.5 days), and higher ISS (14.9) than patients without SCI (P < .0001 for all). Falls were the leading mechanism of injury for patients older than age 64. Univariate analysis identified that long-term survival decreased significantly for all patients older than age 65 (hazard ratio [HR]: 1.07; P < .0001). Multivariate analysis demonstrated age (HR: 1.08; P < .0001), gender (HR: 1.60; P < .0007), and SCI status (HR: 1.45, P < .02) significantly influenced survival during the study period. CONCLUSION: This study identified age, gender, and SCI status as significant variables for this study population influencing long-term survival among patients with cervical spine fractures. Our results support the growing notion that cervical spine injuries in geriatric patients with trauma may warrant additional research. SAGE Publications 2018-05-03 /pmc/articles/PMC5946346/ /pubmed/29760965 http://dx.doi.org/10.1177/2151459318770882 Text en © The Author(s) 2018 http://creativecommons.org/licenses/by-nc/4.0/ This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (http://www.creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage). |
spellingShingle | Original Article Bank, Matthew Gibbs, Katie Sison, Cristina Kutub, Nawshin Papatheodorou, Angelos Lee, Samuel Stein, Adam Bloom, Ona Age and Other Risk Factors Influencing Long-Term Mortality in Patients With Traumatic Cervical Spine Fracture |
title | Age and Other Risk Factors Influencing Long-Term Mortality in Patients With
Traumatic Cervical Spine Fracture |
title_full | Age and Other Risk Factors Influencing Long-Term Mortality in Patients With
Traumatic Cervical Spine Fracture |
title_fullStr | Age and Other Risk Factors Influencing Long-Term Mortality in Patients With
Traumatic Cervical Spine Fracture |
title_full_unstemmed | Age and Other Risk Factors Influencing Long-Term Mortality in Patients With
Traumatic Cervical Spine Fracture |
title_short | Age and Other Risk Factors Influencing Long-Term Mortality in Patients With
Traumatic Cervical Spine Fracture |
title_sort | age and other risk factors influencing long-term mortality in patients with
traumatic cervical spine fracture |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5946346/ https://www.ncbi.nlm.nih.gov/pubmed/29760965 http://dx.doi.org/10.1177/2151459318770882 |
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