Poor Prognostic Factors of Cervical Fracture among Nonagenarians Using the Japanese Diagnosis Procedure Combination Database.

Abstract

Japan has become a super-aging society compared with other countries, with many healthy super-older people surpassing the average life expectancy. Among this population, there are some patients aged >90 years with cervical fracture. However, few clinical studies have investigated cervical fracture among patients aged >90 years, and its clinical features and outcomes have not been fully elucidated. Therefore, this study aimed to explore the descriptive epidemiology of cervical fracture among patients aged >90 years in Japan using a nationwide database. This retrospective study used the Diagnosis Procedure Combination database, which is a nationwide inpatient database covering more than half of all acute-care hospitals in Japan. A total of 977 patients aged >90 years with a confirmed diagnosis of cervical fracture were included in this study. Data were collected, including medical history, diagnoses, treatments, complications, and outcomes. The results showed that the complication rates among patients aged >90 years with cervical fracture were almost the same as those in previous studies, whereas in-hospital mortality in patients with cervical fracture was higher (15.5%). Furthermore, half of the patients aged >90 years with cervical fracture had polytrauma. Older patients with head and spinal cord injuries and cardiac and respiratory complications were more likely to have a poor prognosis. These findings should be considered when treating patients at high risk regardless of surgery. These novel findings provide valuable insights into cervical fracture in patients aged >90 years based on extensive real-world data from Japan, a country with a rapidly aging population.