@article{ref1,
title="Isolated cervical spine fractures in the elderly: a deadly injury",
journal="Journal of trauma",
year="2008",
author="Golob, Joseph F. and Claridge, Jeffrey A. and Yowler, Charles J. and Como, John J. and Peerless, Joel R.",
volume="64",
number="2",
pages="311-315",
abstract="BACKGROUND: Traumatic injury in the elderly is an increasing problem and studies have shown that elderly patients (&gt;/=65 years old) with cervical spine fractures and spinal cord injury (SCI) carry a mortality rate of 21% to 30%. However, little has been described with regard to outcomes for elderly patients with isolated cervical spine fractures (ICSF). HYPOTHESIS: Outcomes for elderly patients with ICSF will be similar to elderly patients with cervical fractures and associated traumatic injuries (ATI) or SCI. METHODS: A 9-year retrospective analysis was performed on all patients &gt;/=65 years old admitted to a level I trauma center with any cervical spine fracture. Primary outcomes were defined as favorable (discharge to home or rehabilitation hospital) or unfavorable (death, discharge to a long-term acute care facility, or a skilled nursing facility). ICSF was defined as those fractures without ATI or SCI. Long-term mortality data were gathered using the Social Security Death Index. RESULTS: A total of 177 patients with mean age of 78 +/- 1 and Injury Severity Score of 17 +/- 1 were evaluated. Fifty-six percent were men and falls were the most common mechanism (62%). An unfavorable outcome was seen in 56% of the study population with a mortality rate of 25%. ATIs were seen in 57% of the population and 22% had SCI. Patients with SCI had a significantly higher mortality compared with patients without SCI (38% vs. 22%, p = 0.032). However, there was no difference in unfavorable outcomes. Patients with ICSF had no differences in unfavorable outcomes compared with patients with SCI or ATI. Long-term survival analysis after discharge (mean = 2.8 years) demonstrated that patients with a favorable outcome had a significantly improved survival compared with patients with unfavorable outcomes (p &lt; 0.001). CONCLUSION: ICSFs were associated with an unfavorable outcome in the elderly population regardless of ATI or SCI. These unfavorable outcomes were also associated with long-term mortality. Strategies to reduce morbidity and mortality in this devastating injury will be essential to improve outcomes and maximize resource utilization.   <p>Language: en</p>",
language="en",
issn="0022-5282",
doi="10.1097/TA.0b013e3181627625",
url="http://dx.doi.org/10.1097/TA.0b013e3181627625"
}