Cervical spine fractures in the elderly - Factors influencing survival in 65 cases

To evaluate whether a cervical spine fracture increases the death risk in e lderly patients, and to define risk factors, we studied the survival of 65 patients (26 women) with a mean age of 77 (66-99) years. 8 of the patients were tetraparetic. In 35 patients, the upper cervical spine was fractured. 7 patients suffered from ankylosing spondylitis. Severe co-morbidity was pr esent in 16. Survival status and the date of death were retrieved from the government of ficial personal registry. The expected survival was calculated from data re trieved from the Swedish National Board of Health and Welfare. Variables ha ving a possible relation with survival (i.e., a p-value < 0.10 when entered into a Kaplan-Meier survival analysis) were used in a Cox multiple regress ion survival analysis. 53 (24-105) months after injury, 25 of the 65 patients had died. The surviv al was significantly lower than the expected values. Severe co-morbidity (r isk ratio: 5,6), neurological injury (6,4), high age (1,1), and ankylosing spondylitis (5,5) proved to be significant risk factors for death. Thus, a cervical spine fracture may lead to earlier death in a patient with a sever e co-morbidity. PI neurological complication constitutes a risk also for a previously healthy individual. Patients having ankylosing spondylitis (with increased death risk) run a higher than normal risk of sustaining a cervic al spine fracture.