Mortality and Readmission After Cervical Fracture from a Fall in Older Adults: Comparison with Hip Fracture Using National Medicare Data

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Mortality and Readmission After Cervical Fracture from a Fall in Older Adults: Comparison with Hip Fracture Using National Medicare Data

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Title: Mortality and Readmission After Cervical Fracture from a Fall in Older Adults: Comparison with Hip Fracture Using National Medicare Data
Author: Cooper, Zara R; Mitchell, Susan Lisa; Lipsitz, Stuart Roger; Harris, Mitchel B; Ayanian, John; Bernacki, Rachelle Emily; Jha, Ashish Kumar

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Citation: Cooper, Zara, Susan L. Mitchell, Stuart Lipsitz, Mitchel B. Harris, John Z. Ayanian, Rachelle E. Bernacki, and Ashish K. Jha. 2015. “Mortality and Readmission After Cervical Fracture from a Fall in Older Adults: Comparison with Hip Fracture Using National Medicare Data.” Journal of the American Geriatrics Society 63 (10) (October): 2036–2042. Portico. doi:10.1111/jgs.13670. h
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Abstract: Background

Cervical fractures from falls are a potentially lethal injury in older patients. Little is known about their epidemiology and outcomes.
Objectives

To examine the prevalence of cervical spine fractures after falls among older Americans and show changes in recent years. Further, to compare 12-month outcomes in patients with cervical and hip fracture after falls.
Design, Setting, and Participants

A retrospective study of Medicare data from 2007–2011 including patients ≥65 with cervical fracture and hip fracture after falls treated at acute care hospitals.
Measurements

Rates of cervical fracture, 12-month mortality and readmission rates after injury.
Results

Rates of cervical fracture increased from 4.6/10,000 in 2007 to 5.3/10,000 in 2011, whereas rates of hip fracture decreased from 77.3/10,000 in 2007 to 63.5/10,000 in 2011. Patients with cervical fracture without and with spinal cord injury (SCI) were more likely than patients with hip fracture, respectively, to receive treatment at large hospitals (54.1%, 59.4% vs. 28.1%, p< 0.001), teaching hospitals (40.0%, 49.3% vs. 13.4%, p< 0.001), and regional trauma centers (38.5%, 46.3% vs. 13.0%, p< 0.001). Patients with cervical fracture, particularly those with SCI, had higher risk-adjusted mortality rates at one year than those with hip fracture (24.5%, 41.7% vs. 22.7%, p<0.001). By one year, more than half of patients with cervical and hip fracture died or were readmitted to the hospital (59.5%, 73.4% vs. 59.3%, p<0.001).
Conclusion

Cervical spine fractures occur in one of every 2,000 Medicare beneficiaries annually and appear to be increasing over time. Patients with cervical fractures had higher mortality than those with hip fractures. Given the increasing prevalence and the poor outcomes of this population, hospitals need to develop processes to improve care for these vulnerable patients.
Published Version: 10.1111/jgs.13670
Other Sources: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4801231/
Terms of Use: This article is made available under the terms and conditions applicable to Open Access Policy Articles, as set forth at http://nrs.harvard.edu/urn-3:HUL.InstRepos:dash.current.terms-of-use#OAP
Citable link to this page: http://nrs.harvard.edu/urn-3:HUL.InstRepos:32784874
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