Nagassima Rodrigues Dos Reis Katharina, McDonnell Jake M, Ahern Daniel P, Evans Shane, Gibbons Denys, Butler Joseph S
National Spinal Injuries Unit, Mater Misericordiae University Hospital, Dublin, Ireland; School of Medicine, Trinity College Dublin, Ireland.
Royal College of Surgeons in Ireland, 123 St Stephen's Green, Dublin, Ireland.
Surgeon. 2022 Dec;20(6):e410-e415. doi: 10.1016/j.surge.2021.08.010. Epub 2021 Sep 30.
Major trauma has seen a demographic shift in recent years and it is expected that the elderly population will comprise a greater burden on the major trauma service in the near future. However, whether a similar trend exists in those undergoing operative intervention for spinal trauma remains to be elucidated.
To compare the presentation and outcomes of patients ≥65 years of age sustaining spine trauma to those <65 years at a national tertiary referral spine centre.
The local Trauma Audit Research Network (TARN) database was analysed to identify spinal patients referred to our institution, a national tertiary referral centre, between 01/2016 and 05/2019. Patients were divided into a young cohort (16-64 years old) and an elderly cohort (> 64 years old). No explicit distinction was made between major and minor spine trauma cases. Variables analysed included patient demographics, injury severity, mortality, interventions, mechanism of injury and length of hospital stay.
A total of 669 patients were admitted of which 480 patients underwent operative intervention for spinal trauma. Within the elderly cohort, this represented 75.3% of cases. Among the younger population, road traffic collisions were the most common mechanism of injury (37.1%), while low falls (<2 m) (57.4%) were the most common mechanism among the older population. Patients ≥65 years old had significantly longer length of stay (21 days [1-194] v 14 days [1-183]) and suffered higher 30-day mortality rates (4.6% [0-12] v 0.97% [0-4]).
Orthopaedic spinal trauma in older people is associated with a significantly higher mortality rate as well as a longer duration of hospitalization. Even though severity of injury is similar for both young and old patients, the mechanism of injury for the older population is of typically much lower energy compared to the high energy trauma affecting younger patients.
近年来，重大创伤的人群结构发生了变化，预计在不久的将来，老年人口将给重大创伤服务带来更大负担。然而，在接受脊柱创伤手术干预的患者中是否存在类似趋势仍有待阐明。
在一家全国性三级转诊脊柱中心，比较65岁及以上脊柱创伤患者与65岁以下患者的临床表现和治疗结果。
分析当地创伤审计研究网络（TARN）数据库，以确定2016年1月至2019年5月期间转诊至我们机构（一家全国性三级转诊中心）的脊柱患者。患者分为年轻队列（16 - 64岁）和老年队列（> 64岁）。脊柱创伤的严重程度和轻微程度病例之间没有明确区分。分析的变量包括患者人口统计学、损伤严重程度、死亡率、干预措施、损伤机制和住院时间。
共收治669例患者，其中480例患者接受了脊柱创伤手术干预。在老年队列中，这占病例的75.3%。在年轻人群中，道路交通事故是最常见的损伤机制（37.1%），而低跌倒（<2米）（57.4%）是老年人群中最常见的机制。65岁及以上患者的住院时间明显更长（21天[1 - 194]对14天[1 - 183]），30天死亡率更高（4.6%[0 - 12]对0.97%[0 - 4]）。
老年人骨科脊柱创伤与显著更高的死亡率以及更长的住院时间相关。尽管年轻和老年患者的损伤严重程度相似，但老年人群的损伤机制通常比影响年轻患者的高能量创伤能量低得多。
