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1-Year Mortality and Surgery Incidence in Older US Adults with Cervical Spine Fracture.

Publication ,  Journal Article
Zeitouni, D; Catalino, M; Kessler, B; Pate, V; Stürmer, T; Quinsey, C; Bhowmick, DA
Published in: World Neurosurg
September 2020

BACKGROUND: Traumatic cervical spinal cord injuries (SCIs) can be lethal and are especially dangerous for older adults. Falls from standing and risk factors for a cervical fracture and spinal cord injury increase with age. This study estimates the 1-year mortality for patients with a cervical fracture and resultant SCI and compares the mortality rate with that from an isolated cervical fracture. METHODS: We performed a retrospective cohort study of U.S. Medicare patients older than 65 years of age. International Classification of Diseases (ICD)-9 codes were used to identify patients with a cervical fracture without SCI and patients with a cervical fracture with SCI between 2007 and 2014. Our primary outcome was 1-year mortality cumulative incidence rate; our secondary outcome was the cumulative incidence rate of surgical intervention. Propensity weighted analysis was performed to balance covariates between the groups. RESULTS: The SCI cohort had a 1-year mortality of 36.5%, compared with 31.1% in patients with an isolated cervical fracture (risk difference 5.4% (2.9%-7.9%)). Patients with an SCI were also more likely to undergo surgical intervention compared with those without a SCI (23.1% and 10.3%, respectively; risk difference 12.8% (10.8%-14.9%)). CONCLUSIONS: Using well-adjusted population-level data in older adults, this study estimates the 1-year mortality after SCI in older adults to be 36.5%. The mortality after a cervical fracture with SCI was 5 percentage points higher than in patients without SCI, and this difference is smaller than one might expect, likely representing the frailty of this population and unmeasured covariates.

Duke Scholars

Published In

World Neurosurg

DOI

EISSN

1878-8769

Publication Date

September 2020

Volume

141

Start / End Page

e858 / e863

Location

United States

Related Subject Headings

  • United States
  • Spinal Fractures
  • Spinal Cord Injuries
  • Risk Factors
  • Retrospective Studies
  • Incidence
  • Humans
  • Cohort Studies
  • Cervical Vertebrae
  • Aged, 80 and over
 

Citation

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Zeitouni, D., Catalino, M., Kessler, B., Pate, V., Stürmer, T., Quinsey, C., & Bhowmick, D. A. (2020). 1-Year Mortality and Surgery Incidence in Older US Adults with Cervical Spine Fracture. World Neurosurg, 141, e858–e863. https://doi.org/10.1016/j.wneu.2020.06.070
Zeitouni, Daniel, Michael Catalino, Brice Kessler, Virginia Pate, Til Stürmer, Carolyn Quinsey, and Deb A. Bhowmick. “1-Year Mortality and Surgery Incidence in Older US Adults with Cervical Spine Fracture.World Neurosurg 141 (September 2020): e858–63. https://doi.org/10.1016/j.wneu.2020.06.070.
Zeitouni D, Catalino M, Kessler B, Pate V, Stürmer T, Quinsey C, et al. 1-Year Mortality and Surgery Incidence in Older US Adults with Cervical Spine Fracture. World Neurosurg. 2020 Sep;141:e858–63.
Zeitouni, Daniel, et al. “1-Year Mortality and Surgery Incidence in Older US Adults with Cervical Spine Fracture.World Neurosurg, vol. 141, Sept. 2020, pp. e858–63. Pubmed, doi:10.1016/j.wneu.2020.06.070.
Zeitouni D, Catalino M, Kessler B, Pate V, Stürmer T, Quinsey C, Bhowmick DA. 1-Year Mortality and Surgery Incidence in Older US Adults with Cervical Spine Fracture. World Neurosurg. 2020 Sep;141:e858–e863.
Journal cover image

Published In

World Neurosurg

DOI

EISSN

1878-8769

Publication Date

September 2020

Volume

141

Start / End Page

e858 / e863

Location

United States

Related Subject Headings

  • United States
  • Spinal Fractures
  • Spinal Cord Injuries
  • Risk Factors
  • Retrospective Studies
  • Incidence
  • Humans
  • Cohort Studies
  • Cervical Vertebrae
  • Aged, 80 and over