Improving life expectancy: A 'broken neck' doesn't have to be a terminal diagnosis for the elderly

Trauma Surgery & Acute Care Open
Laura N GodatRaul Coimbra

Abstract

Elderly patients with cervical spine fractures require optimal care. Treatment with a cervical collar or halo instead of surgical fixation may increase mortality. This investigation intends to describe the life expectancy after injury and evaluate the impact of surgical intervention on mortality. Patients ≥65 years, with traumatic cervical spine fractures without cord injury were identified in the 1995-2009 California Office of Statewide Health and Planning database. Those with halo placement or surgical spine fixation were identified. Primary outcome was death, studied at the initial admission, 30 days, 1 year, and the entire study period. Univariate and multivariate regressions were performed to identify predictors of death. Kaplan-Meier survival curves were used to describe life expectancy after injury. 10 938 patients were identified. Mortality rate was 10% during the initial admission, 28% at 1 year and 50% during the entire study period. A halo was placed in 14% of patients and 12% underwent surgical fixation. Mortality rates during the initial admission were 11% for patients without an intervention, 7% with halo placement and 6% with surgical fixation; at 1 year, these increased to 30%, 26% and 19%, respectively. At 1 ye...Continue Reading

Citations

Mar 23, 2019·Trauma Surgery & Acute Care Open·Christopher J TignanelliKrishnan Raghavendran
Jul 18, 2020·AJNR. American Journal of Neuroradiology·M K O'ReillyJ G Jarvik

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