One-year follow-up for type II odontoid process fractures in octogenarians: Is there a place for surgical management ?

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Serval ID
serval:BIB_3F44765968B5
Type
PhD thesis: a PhD thesis.
Collection
Publications
Institution
Title
One-year follow-up for type II odontoid process fractures in octogenarians: Is there a place for surgical management ?
Author(s)
Borsotti François
Director(s)
BARGES-COLL Juan
Codirector(s)
LEVIVIER Marc
Institution details
Université de Lausanne, Faculté de biologie et médecine
Publication state
Accepted
Issued date
2021
Language
english
Abstract
Background: Type II odontoid fractures are becoming one of the most common injuries among elderly patients and are associated with increased morbidity rates. Here, we compared the safety/efficacy of conservative versus surgical treatment for type II C2 fractures and, in particular, evaluated the complications, hospital lengths of stay, and mortality rates for patients over 80 years of age.
Methods: We retrospectively reviewed the records of 63 nonsurgically versus 18 surgically treated C2 fractures in patients over 80 years of age (2003–2018). Cervical computed tomography images, X-rays, and magnetic resonance images were reviewed by both a neurosurgeon and a neuroradiologist. e following patient data were included in the analysis; Glasgow Coma Scale score, injury severity score, the abbreviated injury scale scores, their comorbidities (e.g., utilizing the Charlson comorbidity index), their primary outcomes, and mortality rates (e.g., at 6 weeks and 1 year after treatment).
Results: Eighty-one patients were included in the study; 63 were treated conservatively and 18 underwent surgical management of type II C2 fractures. Patients averaged 87.0 ± 5.0 years of age, and their combined mortality rates were 13.6% at 6 weeks and 25.9% at 1 year. Notably, at 1 year, the mortality rates were not statistically different between the two groups: 18 (30.0%) patients from the conservatively treated group versus 3 (16.7%) patients from the surgically managed patients died indicating (e.g., using the Kaplan–Meier analysis) no survival advantage for either treatment strategy.
Conclusion: Surgical versus conservative management of type II odontoid fractures were associated with comparable high mortality rates at 1 year.
Keywords
Complications, Mortality, Nonoperative management, Octogenarians, Odontoid fractures, Surgical management
Create date
01/07/2021 9:32
Last modification date
08/10/2021 6:41
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