Abstract
Introduction
Geriatric patients with cervical spine injuries are known to have high morbidity and mortality. Our aim was to evaluate the acute outcomes of geriatric cervical spine injuries in terms of morbidity, mortality, and factors influencing it during hospitalization and after discharge, and the differences between young and old elderly patients.
Material and Methods
Hospital records of 62 geriatric patients with cervical spine injuries from 2003–2014 were retrospectively reviewed and telephonic interview after discharge were done. Patients were divided into young (65- 74yrs) and old (>74yrs) elderly groups. Demographics, mechanism and level of injury, duration of stay (ward/ICU), radiographic findings, neurological deficits, comorbidities, type of management, mortality, factors influencing mortality and complications rates were studied.
Results
45 patients were young elderly and 17 old elderly. Mean age was 70.46 years. 39 sustained high velocity injury and 23 low velocity. C4–5 was the most common injured level. 34 patients had preexisting co-morbid conditions, cardiac was most common. 34 patients underwent surgery. Mean ICU stay was 16.93 days and ward stay 43.94 days. Pulmonary complications were most common in old elderly. Tracheostomy was required in 20 patients and ventilator support in 24 patients. 28 patients had complete deficit, 27 had incomplete neurology and 7 had normal neurology. Mean duration of follow up was 3.2 years. 14 patients died in our series. 10 patients had returned to preinjury functional level. Mortality was more common in old elderly patients with conservative treatment, patients with higher level of neurological deficit, multiple comorbidities, and ventilator dependancy.
Conclusion
Differences exist between young and old elderly with cervical spine injuries, and there are high morbidity, mortality rates. Efforts should be made to reduce pulmonary complications in this age group of patients. Surgical management can be performed reasonably safely when indicated.