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Cervical Injury Outcomes among Older Adults Admitted to an Inpatient Trauma Service

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The journal of nutrition, health & aging

Abstract

Objective

Older adults are an increasing proportion of patients admitted to trauma services. Trauma in older adults’ results from many mechanisms of injury with the distribution of mechanisms of injury among older adults different than those of younger adults. The acute management of these injuries may determine the patients’ ability to return to independent living. It is known that prolonged immobilization of older patients results in deterioration of their functional status and increases the likelihood of hospital acquired complications, notably pneumonia, delirium, and loss of ambulation.

Design/Setting

We reviewed 213 patients aged 65 and older admitted to our trauma services who sustained cervical spine injuries that were either placed in c spine immobilization or were not to understand the outcomes associated with their mechanism of injury.

Results

The youngest patients (65–74 years) were proportionately more likely to have sustained high energy injuries associated with motor vehicle crashes (36%) with a mortality rate of 11.5%. The oldest age group (> 85 years) had a higher mortality rate from falls from standing injuries (31%). Patients discharged with a collar were more likely to return to independent living. In addition, 96% of the patients that died in the acute care setting were not in cervical collar immobilization.

Conclusion

Patients under 85 years with a cervical spine injury should be placed in c-spine immobilization and aggressively managed with a multidisciplinary team approach. The older adult trauma population requires specialty care including rapid cervical spine evaluation and prescreening of functional status on admission. The NEXUS guideline should be enhanced for the older adult trauma population.

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Author information

Authors and Affiliations

  1. Trauma Research Coordinator, SSM Health Saint Louis University Hospital, Assistant Professor Saint Louis University, 3525 Caroline Street, St. Louis, MO, 63104, USA

    Vicki Moran

  2. Northwestern Medicine, Chicago, USA

    T. Pulliam

  3. IM-Geriatrics, Saint Louis University, St. Louis, USA

    M. Rodin

  4. Division Chief for Trauma Surgery, SSM Health Saint Louis University Hospital, Associate Professor of Surgery, Saint Louis University, St. Louis, USA

    C. Freeman

  5. Associate Research Professor, Orthopaedic Surgery, Saint Louis University, St. Louis, USA

    H. Israel

Authors
  1. Vicki Moran
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  2. T. Pulliam
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  3. M. Rodin
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  4. C. Freeman
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  5. H. Israel
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Corresponding author

Correspondence to Vicki Moran.

Ethics declarations

Conflict of interest: The authors declare no conflict of interest. No funding was received for the research involved in the manuscript.

Ethical standard: This study was guided by the Saint Louis University Institutional Review Board#28203 following the ethical principles regarding all research involving humans as subjects, as set forth in the Ethical Principles and Guidelines for the Protection of Human Subjects of Reserach.

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Moran, V., Pulliam, T., Rodin, M. et al. Cervical Injury Outcomes among Older Adults Admitted to an Inpatient Trauma Service. J Nutr Health Aging 25, 392–398 (2021). https://doi.org/10.1007/s12603-021-1589-3

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  • DOI: https://doi.org/10.1007/s12603-021-1589-3

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