Prognosis and mortality rate of elderly patients with traumatic cervical spinal cord injury

Abstract

Introduction: In recent years, the incidence of traumatic spinal cord injury in elderly patients has increased. This study aimed to investigate the prognosis and in-hospital mortality rate of elderly patients with traumatic cervical spinal cord injury and cervical spine fractures.

Methods: We retrospectively reviewed 38 patients (11 females and 27 males) with cervical spinal cord injury aged ≥65 years who were treated at our hospital between January 2012 and December 2021. The patients had a mean age of 76 years and were divided into surgical and conservative groups.

Results: The conservative group had higher rates of patients with Frankel grade A than the surgical group. Additionally, 28.9% of the patients died during hospitalization. The mortality rates were higher in the conservative group than in the surgical group (64.2% vs.8.3%, respectively). In patients with Frankel grade A and/or B, the rate of respiratory support (ventilation or oxygen inhalation) and tube feeding tended to be higher in the surgical group (p = 0.07 and p = 0.05, respectively). Furthermore, 81.8% of patients with Frankel grade A or B in the surgical group required respiratory support and/or tube feeding, while 70% of the patients in the conservative group died during hospitalization.

Conclusion: These results may be used to inform clinical decision-making and discussions with elderly patients with spinal cord injury and their families.