Department of Orthopedics, Trauma and Plastic Surgery, University of Leipzig, Liebigstrasse 20, 04103, Leipzig, Germany.
Clinic for Trauma Surgery and Orthopaedics, Munich Harlaching, Sanatoriumspl. 2, 81545, München, Germany.
Eur Spine J. 2024 Dec;33(12):4504-4512. doi: 10.1007/s00586-024-08520-2. Epub 2024 Oct 22.
There is a gap in evidence about medical outcomes in oldest-old patients (aged 85 and older) with vertebral fractures (VFs). The aim of this study was to evaluate the impact of patient and fracture characteristics on "short-term" hospital outcomes.
All patients aged ≥ 85 presenting an acute or subsequent VF at our single level I spine center between 2019 and 2021 requiring hospital treatment were included. The data collection was conducted retrospectively. The primary parameters of interest were length of stay (LOS) and in-hospital mortality. Further outcome parameters were the occurrence of general (non-operative) complications and Intensive Care Unit (ICU) admission. For statistical analysis, linear and binary logistic regression modeling were performed.
A total of 153 patients with an average age of 88.5 (range 85 to 99) met the inclusion criteria. Our patients were mostly female (68.6%) and moderately comorbid according to a Charlson Comorbidity Index (CCI) of 2.9. 58.8% had diagnosed osteoporosis. Fracture morphologies represented as "Osteoporotic Fracture" (OF) classification types were of central importance for undergoing operative treatment (OP) (p < 0.001), necessity for intensive care (p = 0.023), LOS (p = 0.014), and mortality (p = 0.018). 38.6% had OP. We recorded a complication rate of 59.5%, which highly influenced (p < 0.001) both primary outcome parameters. Overall, patients stayed 14.6 days with a mortality of 11.1%.
VFs are a severe event in oldest-old patients with a crucial risk of poor medical outcomes during hospitalization. The fracture morphologies are of central importance. However, little is known about the hospital stay of oldest-old inpatients with VFs. Considering an aging population, further investigations would be recommended.
在 85 岁及以上的老年椎体骨折（VF）患者中，有关医疗结局的证据存在差距。本研究旨在评估患者和骨折特征对“短期”住院结局的影响。
本研究纳入了 2019 年至 2021 年在我们的一级脊柱中心因急性或后续 VF 而需要住院治疗的所有年龄≥85 岁的患者。数据采集采用回顾性方法。主要观察指标为住院时间（LOS）和住院死亡率。进一步的结局参数为一般（非手术）并发症和重症监护病房（ICU）入住的发生情况。采用线性和二项逻辑回归模型进行统计分析。
共纳入 153 名平均年龄为 88.5 岁（85 岁至 99 岁）的患者。患者主要为女性（68.6%），根据 Charlson 合并症指数（CCI）为 2.9 存在中度合并症。58.8%诊断为骨质疏松症。骨折形态作为“骨质疏松性骨折”（OF）分类类型对于接受手术治疗（OP）（p<0.001）、需要重症监护（p=0.023）、LOS（p=0.014）和死亡率（p=0.018）具有重要意义。38.6%接受了 OP。我们记录的并发症发生率为 59.5%，这对主要结局参数有很大影响（p<0.001）。总体而言，患者的住院时间为 14.6 天，死亡率为 11.1%。
VF 是老年患者的严重事件，住院期间有严重的医疗结局不良风险。骨折形态具有重要意义。然而，关于老年住院患者 VF 的住院时间知之甚少。考虑到人口老龄化，建议进一步研究。
