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Identifying factors influencing mortality in patients aged over 65 following an acute type II odontoid process fracture. A retrospective cohort study.
- Source :
-
European Spine Journal . Jun2021, Vol. 30 Issue 6, p1551-1555. 5p. 3 Charts. - Publication Year :
- 2021
-
Abstract
- Objective: Compare short-term mortality rates following operative and nonoperative management of geriatric patients following an acute type II odontoid process fracture. Methods: One hundred forty-one patients with a type II odontoid fracture were identified from a single centre between 2002 and 2018. Patient demographics, details of injury and management, plus mortality data were collected. The incidence of mortality at 3 and 12 months was calculated, and a multivariate model built which included the treatment modality variable and allowed adjustment for six individual confounders. Results: Of the 141 patients with a type II odontoid process fracture, 39 were managed operatively, while 102 were managed nonoperatively. Relative to the nonoperative group, the operative group was younger (79.0 ± 7.0 vs. 83.7 ± 7.6), more likely to have odontoid angulation > 15° (74.4% vs. 43.1%, p < 0.01), and a greater proportion having fracture displacement > 2 mm (74.4% vs. 31.4%, p < 0.01). Both groups were comparable for gender, comorbidities, and associated injuries. On univariate analysis of treatment modality, the odds ratio of 3-month mortality with nonoperative management was 2.55 (95% CI: 0.82–7.92; p = 0.08), whilst at 12-months it was 3.12 (95% CI: 1.11–8.69; p = 0.02). On multivariate analysis of 12-month mortality, however, treatment modality was not found to be significant. This multivariate analysis suggested that increasing age, male gender, and injury severity were significant predictors of 12-month mortality. Conclusion: In contrast to the findings of a number of previous studies, operative management may not influence survival at 3- and 12-months. [ABSTRACT FROM AUTHOR]
- Subjects :
- *COHORT analysis
*GENDER
*MORTALITY
*DEATH rate
*MULTIVARIATE analysis
Subjects
Details
- Language :
- English
- ISSN :
- 09406719
- Volume :
- 30
- Issue :
- 6
- Database :
- Academic Search Index
- Journal :
- European Spine Journal
- Publication Type :
- Academic Journal
- Accession number :
- 151401943
- Full Text :
- https://doi.org/10.1007/s00586-020-06694-z