Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa University, 13-1 Takara-machi, Kanazawa, Ishikawa, 920-8641, Japan.
Department of Orthopedics Surgery, Toyama Prefectural Central Hospital, Toyama, Japan.
Sci Rep. 2022 Sep 23;12(1):15867. doi: 10.1038/s41598-022-19789-y.
Although traumatic cervical spine injuries in older adults are commonly caused by minor traumas, such as ground-level falls, their prognosis is often unfavorable. Studies examining the clinical characteristics of cervical spine injuries in older adults according to the external cause of injury are lacking. This study included 1512 patients of ≥ 65 years of age with traumatic cervical spine injuries registered in a Japanese nationwide multicenter database. The relationship between the external causes and clinical characteristics, as well as factors causing unfavorable outcomes at the ground-level falls, were retrospectively reviewed and examined. When fall-induced cervical spine injuries were categorized and compared based on fall height, the patients' backgrounds and injury statuses differed significantly. Of note, patients injured from ground-level falls tended to have poorer pre-injury health conditions, such as medical comorbidities and frailty, compared with those who fell from higher heights. For ground-level falls, the mortality, walking independence, and home-discharge rates at 6 months post-injury were 9%, 67%, and 80%, respectively, with preexisting medical comorbidities and frailty associated with unfavorable outcomes, independent of age or severity of neurological impairment at the time of injury.
尽管老年人的创伤性颈椎损伤通常由轻微创伤引起，如平地跌倒，但他们的预后往往不佳。缺乏根据损伤外部原因研究老年人颈椎损伤临床特征的研究。本研究纳入了日本全国多中心数据库中登记的 1512 名≥65 岁的创伤性颈椎损伤患者。回顾性分析和检查了外部原因与临床特征之间的关系，以及导致平地跌倒不良结局的因素。当根据跌倒高度对跌倒引起的颈椎损伤进行分类和比较时，患者的背景和损伤状况存在显著差异。值得注意的是，与从较高高度跌倒的患者相比，平地跌倒的患者受伤前的健康状况较差，如合并症和虚弱。对于平地跌倒，受伤后 6 个月的死亡率、独立行走率和出院回家率分别为 9%、67%和 80%，合并症和虚弱与预后不良相关，与年龄或受伤时的神经损伤严重程度无关。
