학술논문
Effects of Dementia on Outcomes after Cervical Spine Injuries in Elderly Patients: Evaluation of 1512 Cases in a Nationwide Multicenter Study in Japan
Document Type
Academic Journal
Author
Yamada, Yohei; Yokogawa, Noriaki; Kato, Satoshi; Sasagawa, Takeshi; Tsuchiya, Hiroyuki; Nakashima, Hiroaki; Segi, Naoki; Ito, Sadayuki; Funayama, Toru; Eto, Fumihiko; Yamaji, Akihiro; Yamane, Junichi; Nori, Satoshi; Furuya, Takeo; Yunde, Atsushi; Nakajima, Hideaki; Yamada, Tomohiro; Hasegawa, Tomohiko; Terashima, Yoshinori; Hirota, Ryosuke; Suzuki, Hidenori; Imajo, Yasuaki; Ikegami, Shota; Uehara, Masashi; Tonomura, Hitoshi; Sakata, Munehiro; Hashimoto, Ko; Onoda, Yoshito; Kawaguchi, Kenichi; Haruta, Yohei; Suzuki, Nobuyuki; Kato, Kenji; Uei, Hiroshi; Sawada, Hirokatsu; Nakanishi, Kazuo; Misaki, Kosuke; Terai, Hidetomi; Tamai, Koji; Kuroda, Akiyoshi; Inoue, Gen; Kakutani, Kenichiro; Kakiuchi, Yuji; Kiyasu, Katsuhito; Tominaga, Hiroyuki; Tokumoto, Hiroto; Iizuka, Yoichi; Takasawa, Eiji; Akeda, Koji; Takegami, Norihiko; Funao, Haruki; Oshima, Yasushi; Kaito, Takashi; Sakai, Daisuke; Yoshii, Toshitaka; Ohba, Tetsuro; Otsuki, Bungo; Seki, Shoji; Miyazaki, Masashi; Ishihara, Masayuki; Okada, Seiji; Imagama, Shiro; Watanabe, Kota
Source
Journal of Clinical Medicine. February 2023, Vol. 12 Issue 5
Subject
Language
English
ISSN
2077-0383
Abstract
Author(s): Yohei Yamada [1]; Noriaki Yokogawa [1]; Satoshi Kato (corresponding author) [1,*]; Takeshi Sasagawa [1,2]; Hiroyuki Tsuchiya [1]; Hiroaki Nakashima [3]; Naoki Segi [3]; Sadayuki Ito [3]; Toru Funayama [4]; [...]
We aimed to retrospectively investigate the demographic characteristics and short-term outcomes of traumatic cervical spine injuries in patients with dementia. We enrolled 1512 patients aged ≥ 65 years with traumatic cervical injuries registered in a multicenter study database. Patients were divided into two groups according to the presence of dementia, and 95 patients (6.3%) had dementia. Univariate analysis revealed that the dementia group comprised patients who were older and predominantly female and had lower body mass index, higher modified 5-item frailty index (mFI-5), lower pre-injury activities of daily living (ADLs), and a larger number of comorbidities than patients without dementia. Furthermore, 61 patient pairs were selected through propensity score matching with adjustments for age, sex, pre-injury ADLs, American Spinal Injury Association Impairment Scale score at the time of injury, and the administration of surgical treatment. In the univariate analysis of the matched groups, patients with dementia had significantly lower ADLs at 6 months and a higher incidence of dysphagia up to 6 months than patients without dementia. Kaplan–Meier analysis revealed that patients with dementia had a higher mortality than those without dementia until the last follow-up. Dementia was associated with poor ADLs and higher mortality rates after traumatic cervical spine injuries in elderly patients.
We aimed to retrospectively investigate the demographic characteristics and short-term outcomes of traumatic cervical spine injuries in patients with dementia. We enrolled 1512 patients aged ≥ 65 years with traumatic cervical injuries registered in a multicenter study database. Patients were divided into two groups according to the presence of dementia, and 95 patients (6.3%) had dementia. Univariate analysis revealed that the dementia group comprised patients who were older and predominantly female and had lower body mass index, higher modified 5-item frailty index (mFI-5), lower pre-injury activities of daily living (ADLs), and a larger number of comorbidities than patients without dementia. Furthermore, 61 patient pairs were selected through propensity score matching with adjustments for age, sex, pre-injury ADLs, American Spinal Injury Association Impairment Scale score at the time of injury, and the administration of surgical treatment. In the univariate analysis of the matched groups, patients with dementia had significantly lower ADLs at 6 months and a higher incidence of dysphagia up to 6 months than patients without dementia. Kaplan–Meier analysis revealed that patients with dementia had a higher mortality than those without dementia until the last follow-up. Dementia was associated with poor ADLs and higher mortality rates after traumatic cervical spine injuries in elderly patients.