TY - JOUR
T1 - Thoracolumbar spinal fractures associated with ground level falls in the elderly
T2 - An analysis of 254,486 emergency department visits
AU - Grabel, Zachary J.
AU - Lunati, Matthew P.
AU - Segal, Dale N.
AU - Kukowski, Nathan R.
AU - Yoon, S. Tim
AU - Jain, Amit
N1 - Publisher Copyright:
© 2020
PY - 2020/9/1
Y1 - 2020/9/1
N2 - Study design: retrospective. Objectives: To investigate the epidemiology of elderly (age ≥65 years) patients who presented to the emergency department (ED) in the United States with thoracolumbar (TL) fractures after ground level falls. Methods: Using the National Emergency Department Sample database, we queried all ED visits in the United States from 2009 through 2012 of elderly patients who presented after ground level falls. We identified patients who sustained TL fractures with and without neurological injury. Resulting data was used to analyze the fracture prevalence, ED and patient characteristics, associated injuries, treatment patterns, inpatient mortality, and hospital charges. Results: Of the 6,654,526 ED visits in the elderly for ground level falls, 254,486 (3.8%) were associated with a diagnosis of TL fracture. 39% patients had multiple injuries, and upper extremity fractures were the most common associated injuries. Overall, 55.6% were admitted to the hospital. Of those, 77.7% were treated non-operatively, 20.4% were treated with cement augmentation alone, 1.5% were treated with spinal fusion surgery, and 0.4% were treated with spinal decompression alone. The overall rate of inpatient mortality was 2.14%. Conclusions: This investigation evaluated the epidemiology of elderly patients who presented to the ED in the United States with TL fractures after ground level falls. The study demonstrated a rather high incidence of TL fractures in this patient cohort. As a result, it is important for ED physicians and orthopaedic surgeons to be highly suspicious of TL fractures in elderly patients who sustain low energy trauma. With the continued aging of the population and rising health care costs, future effort ought to focus on fall prevention and increased surveillance for TL injuries in the elderly.
AB - Study design: retrospective. Objectives: To investigate the epidemiology of elderly (age ≥65 years) patients who presented to the emergency department (ED) in the United States with thoracolumbar (TL) fractures after ground level falls. Methods: Using the National Emergency Department Sample database, we queried all ED visits in the United States from 2009 through 2012 of elderly patients who presented after ground level falls. We identified patients who sustained TL fractures with and without neurological injury. Resulting data was used to analyze the fracture prevalence, ED and patient characteristics, associated injuries, treatment patterns, inpatient mortality, and hospital charges. Results: Of the 6,654,526 ED visits in the elderly for ground level falls, 254,486 (3.8%) were associated with a diagnosis of TL fracture. 39% patients had multiple injuries, and upper extremity fractures were the most common associated injuries. Overall, 55.6% were admitted to the hospital. Of those, 77.7% were treated non-operatively, 20.4% were treated with cement augmentation alone, 1.5% were treated with spinal fusion surgery, and 0.4% were treated with spinal decompression alone. The overall rate of inpatient mortality was 2.14%. Conclusions: This investigation evaluated the epidemiology of elderly patients who presented to the ED in the United States with TL fractures after ground level falls. The study demonstrated a rather high incidence of TL fractures in this patient cohort. As a result, it is important for ED physicians and orthopaedic surgeons to be highly suspicious of TL fractures in elderly patients who sustain low energy trauma. With the continued aging of the population and rising health care costs, future effort ought to focus on fall prevention and increased surveillance for TL injuries in the elderly.
KW - Elderly
KW - Ground level falls
KW - Mortality
KW - Thoracolumbar fractures
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U2 - 10.1016/j.jcot.2020.04.009
DO - 10.1016/j.jcot.2020.04.009
M3 - Article
C2 - 32879581
AN - SCOPUS:85083338603
SN - 0976-5662
VL - 11
SP - 916
EP - 920
JO - Journal of Clinical Orthopaedics and Trauma
JF - Journal of Clinical Orthopaedics and Trauma
IS - 5
ER -