Àá½Ã¸¸ ±â´Ù·Á ÁÖ¼¼¿ä. ·ÎµùÁßÀÔ´Ï´Ù.
KMID : 1189320190130040563
Asian Spine Journal
2019 Volume.13 No. 4 p.563 ~ p.568
Factors Impacting Mortality in Geriatric Patients with Acute Spine Fractures: A 12-Year Study of 613 Patients in Singapore
Soon En Loong

Leong Adriel Zhijie
Chiew Jean
Kaliya-Perumal Arun-Kumar
Yu Chun Sing
Oh Jacob Yoong-Leong
Abstract
Study Design: Retrospective database analysis.

Purpose: To identify risk factors that predict mortality following acute spine fractures in geriatric patients of Singapore.

Overview of Literature: Acute geriatric spinal fractures contribute significantly to local healthcare costs and hospital admissions. However, geriatric mortality following acute spine fractures is scarcely assessed in the Asian population.

Methods: Electronic records of 3,010 patients who presented to our hospital¡¯s emergency department and who were subsequently admitted during 2004?2015 with alleged history of traumatic spine fractures were retrospectively reviewed, and 613 patients (mean age, 85.7¡¾4.5 years; range, 80?101 years; men, 108; women, 505) were shortlisted. Mortality rates were reviewed up to 1 year after admission and multivariate analyses were performed to identify independent risk factors correlating with mortality.

Results: Women were more susceptible to spine fractures (82.4%), with falls (77.8%) being the most common mechanism of injury. Mortality rates were 6.0%, 8.2%, and 10.4% at 3, 6, and 12 months, respectively. The most common causes of death at all 3 time points were pneumonia and ischemic heart disease. Based on the multivariate analysis at 1-year follow-up, elderly women had a lower mortality rate compared to men (p<0.001); mortality rates increased by 6.3% (p=0.024) for every 1-year increase in the patient¡¯s age; and patients with an American Spinal Injury Association (ASIA) score of A?C had a much higher mortality rate compared to those with an ASIA score of D?E (p<0.001).

Conclusions: An older age at presentation, male sex, and an ASIA score of A?C were identified as independent factors predicting increased mortality among geriatric patients who sustained acute spine fractures. The study findings highlight at-risk groups for acute spine fractures, thereby providing an opportunity to develop strategies to increase the life expectancy of these patients.
KEYWORD
Accidental falls, Mortality, Spinal cord injuries, Spinal fractures, Spinal injuries
FullTexts / Linksout information
 
Listed journal information
KoreaMed