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

被引：4

作者：

Kobayashi, Motoya ^{[1
]}

Yokogawa, Noriaki ^{[1
]}

Kato, Satoshi ^{[1
]}

Sasagawa, Takeshi ^{[1
,2
]}

Tsuchiya, Hiroyuki ^{[1
]}

Nakashima, Hiroaki ^{[3
]}

Segi, Naoki ^{[3
]}

Ito, Sadayuki ^{[3
]}

Funayama, Toru ^{[4
]}

Eto, Fumihiko ^{[5
]}

Yamaji, Akihiro ^{[6
]}

Yamane, Junichi ^{[7
]}

Nori, Satoshi ^{[8
]}

Furuya, Takeo ^{[9
]}

Yunde, Atsushi ^{[9
]}

Nakajima, Hideaki ^{[10
]}

Yamada, Tomohiro ^{[11
,12
]}

Hasegawa, Tomohiko ^{[11
]}

Terashima, Yoshinori ^{[13
,14
]}

Hirota, Ryosuke ^{[13
]}

Suzuki, Hidenori ^{[15
]}

Imajo, Yasuaki ^{[15
]}

Ikegami, Shota ^{[16
]}

Uehara, Masashi ^{[16
]}

Tonomura, Hitoshi ^{[17
]}

Sakata, Munehiro ^{[17
,18
]}

Hashimoto, Ko ^{[19
]}

Onoda, Yoshito ^{[19
]}

Kawaguchi, Kenichi ^{[20
]}

Haruta, Yohei ^{[20
]}

Suzuki, Nobuyuki ^{[21
]}

Kato, Kenji ^{[21
]}

Uei, Hiroshi ^{[22
,23
]}

Sawada, Hirokatsu ^{[23
]}

Nakanishi, Kazuo ^{[24
]}

Misaki, Kosuke ^{[24
]}

Terai, Hidetomi ^{[25
]}

Tamai, Koji ^{[25
]}

Kuroda, Akiyoshi ^{[26
]}

Inoue, Gen ^{[26
]}

Kakutani, Kenichiro ^{[27
]}

Kakiuchi, Yuji ^{[27
]}

Kiyasu, Katsuhito ^{[28
]}

Tominaga, Hiroyuki ^{[29
]}

Tokumoto, Hiroto ^{[29
]}

Iizuka, Yoichi ^{[30
]}

Takasawa, Eiji ^{[30
]}

Akeda, Koji ^{[31
]}

Takegami, Norihiko ^{[31
]}

Funao, Haruki ^{[32
,33
,34
,35
]}

机构：

[1] Kanazawa Univ, Grad Sch Med Sci, Dept Orthopaed Surg, Kanazawa 9208641, Japan

[2] Toyama Prefectural Cent Hosp, Dept Orthopaed Surg, Toyama 9308550, Japan

[3] Nagoya Univ, Grad Sch Med, Dept Orthoped Surg, Nagoya 4668550, Japan

[4] Univ Tsukuba, Fac Med, Dept Orthopaed Surg, Tsukuba 3058575, Japan

[5] Univ Tsukuba, Grad Sch Comprehens Human Sci, Dept Orthopaed Surg, Tsukuba 3058575, Japan

[6] Ibaraki Seinan Med Ctr Hosp, Dept Orthopaed Surg, Sakai 3060433, Japan

[7] Natl Hosp Org, Dept Orthopaed Surg, Murayama Med Ctr, Tokyo 2080011, Japan

[8] Keio Univ, Dept Orthopaed Surg, Sch Med, Tokyo 1608582, Japan

[9] Chiba Univ, Grad Sch Med, Dept Orthopaed Surg, Chiba 2608670, Japan

[10] Univ Fukui, Fac Med Sci, Dept Orthopaed & Rehabil Med, Osaka 9101193, Japan

[11] Hamamatsu Univ, Dept Orthopaed Surg, Sch Med, Shizuoka 4313192, Japan

[12] Nagoya Kyoritsu Hosp, Dept Orthopaed Surg, Nagoya 4540933, Japan

[13] Sapporo Med Univ, Dept Orthopaed Surg, Sapporo 0608543, Japan

[14] Matsuda Orthoped Mem Hosp, Dept Orthopaed Surg, Sapporo 0010018, Japan

[15] Yamaguchi Univ, Dept Orthopaed Surg, Grad Sch Med, Yamaguchi 7558505, Japan

[16] Shinshu Univ, Dept Orthopaed Surg, Sch Med, Nagano 3908621, Japan

[17] Kyoto Prefectural Univ Med, Grad Sch Med Sci, Dept Orthopaed, Kyoto 6028566, Japan

[18] Saiseikai Shiga Hosp, Dept Orthopaed, Ritto 5203046, Japan

[19] Tohoku Univ, Dept Orthopaed Surg, Grad Sch Med, Sendai 9808574, Japan

[20] Kyushu Univ, Grad Sch Med Sci, Dept Orthopaed Surg, 3-1-1 Maidashi Higashi Ku, Fukuoka 8128582, Japan

[21] Nagoya City Univ, Dept Orthopaed Surg, Grad Sch Med Sci, Nagoya 4678601, Japan

[22] Nihon Univ Hosp, Dept Orthopaed Surg, Tokyo 1018393, Japan

[23] Nihon Univ, Dept Orthopaed Surg, Sch Med, Tokyo 1738610, Japan

[24] Kawasaki Med Sch, Dept Orthoped Traumatol & Spine Surg, Okayama 7010192, Japan

[25] Osaka Metropolitan Univ, Dept Orthopaed Surg, Grad Sch Med, Osaka 5458585, Japan

[26] Kitasato Univ, Dept Orthopaed Surg, Sch Med, Sagamihara 2520374, Japan

[27] Kobe Univ, Dept Orthopaed Surg, Grad Sch Med, Kobe 6500017, Japan

[28] Kochi Univ, Kochi Med Sch, Dept Orthopaed Surg, Nankoku 7838505, Japan

[29] Kagoshima Univ, Grad Sch Med & Dent Sci, Dept Orthopaed Surg, Kagoshima 8908520, Japan

[30] Gunma Univ, Dept Orthopaed Surg, Grad Sch Med, Maebashi 3718511, Japan

[31] Mie Univ, Dept Orthopaed Surg, Grad Sch Med, Tsu 5148507, Japan

[32] Int Univ Hlth & Welf, Sch Med, Dept Orthopaed Surg, Chiba 2860124, Japan

[33] Int Univ Hlth & Welf, Narita Hosp, Dept Orthopaed Surg, Chiba 2860124, Japan

[34] Int Univ Hlth & Welf, Mita Hosp, Dept Orthopaed Surg, Tokyo 1088329, Japan

[35] Int Univ Hlth & Welf, Mita Hosp, Spine & Spinal Cord Ctr, Tokyo 1088329, Japan

[36] Univ Tokyo Hosp, Dept Orthopaed Surg, Tokyo 1138655, Japan

[37] Osaka Univ, Dept Orthopaed Surg, Grad Sch Med, Osaka 5650871, Japan

[38] Tokai Univ, Dept Orthoped Surg Surg Sci, Sch Med, Isehara 2591193, Japan

[39] Tokyo Med & Dent Univ, Dept Orthopaed Surg, Tokyo 1138519, Japan

[40] Univ Yamanashi, Dept Orthopaed Surg, Yamanashi 4093898, Japan

[41] Kyoto Univ, Grad Sch Med, Dept Orthopaed Surg, Kyoto 6068507, Japan

[42] Univ Toyama, Fac Med, Dept Orthopaed Surg, Toyama 9300194, Japan

[43] Oita Univ, Fac Med, Dept Orthopaed Surg, Yufu 8795593, Japan

来源：

JOURNAL OF CLINICAL MEDICINE | 2023年 / 12卷 / 02期

关键词：

risk factor; cervical spine injury; chronic kidney disease; prognostic factor; early mortality; CHRONIC KIDNEY-DISEASE; CORD-INJURY; COMPLICATIONS; FRACTURES; MANAGEMENT; SURGERY; DEATH; AGE;

D O I：

10.3390/jcm12020708

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

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.

引用

页数：12

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