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Risk Factors for Early Mortality in Older Patients with Traumatic Cervical Spine Injuries-A Multicenter Retrospective Study of 1512 Cases.

Motoya KobayashiNoriaki YokogawaSatoshi KatoTakeshi SasagawaHiroyuki TsuchiyaHiroaki NakashimaNaoki SegiSadayuki ItoToru FunayamaFumihiko EtoAkihiro YamajiJunichi YamaneSatoshi NoriTakeo FuruyaAtsushi YundeHideaki NakajimaTomohiro YamadaTomohiko HasegawaYoshinori TerashimaRyosuke HirotaHidenori SuzukiYasuaki ImajoShota IkegamiMasashi UeharaHitoshi TonomuraMunehiro SakataKo HashimotoYoshito OnodaKenichi KawaguchiYohei HarutaNobuyuki SuzukiKenji KatoHiroshi UeiHirokatsu SawadaKazuo NakanishiKosuke MisakiHidetomi TeraiKoji TamaiAkiyoshi KurodaGen InoueKenichiro KakutaniYuji KakiuchiKatsuhito KiyasuHiroyuki TominagaHiroto TokumotoYoichi IizukaEiji TakasawaKoji AkedaNorihiko TakegamiHaruki FunaoYasushi OshimaTakashi KaitoDaisuke SakaiToshitaka YoshiiTetsuro OhbaBungo OtsukiShoji SekiMasashi MiyazakiMasayuki IshiharaSeiji OkadaShiro ImagamaKota Watanabe
Published in: Journal of clinical medicine (2023)
For older patients with decreased reserve function, traumatic cervical spine injuries frequently lead to early mortality. However, the prognostic factors for early mortality remain unclear. This study included patients aged ≥65 years and hospitalized for treatment of traumatic cervical spine injuries in 78 hospitals between 2010 and 2020. Early mortality was defined as death within 90 days after injury. We evaluated the relationship between early mortality and the following factors: age, sex, body mass index, history of drinking and smoking, injury mechanisms, presence of a cervical spine fracture and dislocation, cervical ossification of the posterior longitudinal ligament, diffuse idiopathic skeletal hyperostosis, American Spinal Injury Association Impairment Scale, concomitant injury, pre-existing comorbidities, steroid administration, and treatment plan. Overall, 1512 patients (mean age, 75.8 ± 6.9 years) were included in the study. The early mortality rate was 4.0%. Multivariate analysis identified older age (OR = 1.1, p < 0.001), male sex (OR = 3.7, p = 0.009), cervical spine fracture (OR = 4.2, p < 0.001), complete motor paralysis (OR = 8.4, p < 0.001), and chronic kidney disease (OR = 5.3, p < 0.001) as risk factors for early mortality. Older age, male sex, cervical spine fracture, complete motor paralysis, and chronic kidney disease are prognostic factors for early mortality in older patients with traumatic cervical spine injuries.
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