Mortality for Spinal Cord Injury Tied to C-Spine Fracture

(HealthDay News) – For older adults with spinal cord injuries (SCIs) related to cervical spine (C-spine) fractures, injury level and severity of SCI are risk factors for mortality, according to a study published in the August issue of The Spine Journal.

Parham Daneshvar, MD, from the University of Ottawa in Canada, and colleagues conducted a retrospective cohort study at two Level 1 trauma centers involving 37 consecutive patients aged >60 years with SCIs related to C-spine fractures. The mortality rate was determined and risk factors for negative outcomes examined.

The researchers found that the in-hospital mortality rate was 38%, with the leading cause of death being respiratory failure. Pre-injury medical comorbidities, age, or operative vs. non-operative treatment had no impact on mortality. The risk of mortality was 7.1 times higher for injury level at or above C4 vs. below C4 (P=0.01), and was 5.1 times higher for complete SCI versus incomplete SCI (P=0.03). Neurological recovery was found to be uncommon. Severity of initial SCI was the only factor related to ambulatory disposition at discharge.

“In summary, a complete SCI and a high level of injury significantly increased the risk of mortality in elderly patients,” the authors write. “Using this knowledge, physicians may be able to better determine prognosis and treatment in elderly patients with C-spine fractures and concomitant SCI.”

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