bedridden patient, family member and doctor in hospital room
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The rates of death after emergency spine fracture surgery in older adults are high, but how do they compare to emergency surgeries for other common fractures in older adults, such as hip fractures? Death rates were higher in those with spine surgeries, authors of a new study found.

The study, which was published on Tuesday in Cureus, compared the death rates within 30 days of surgery and risk factors between the two types of surgeries. Researchers used data from the National Surgical Quality Improvement Program database between the years of 2011 and 2021. The team assessed 18,287 emergency hip fractures and 192 emergency spine fractures.

There were significant differences in factors such as sex, body mass index (BMI), operation time, length of hospital stays and others between spine and hip fractures. The 30-day mortality rates were 9.4% in spine surgery compared to 5% in hip fractures. Emergent spine fracture surgery, disseminated cancer, functional dependence, and length of stay were independent predictors of mortality. Female sex, BMI, and operation time were protective factors against mortality.

Overall, emergency spine fractures in older adults are an independent predictor for death within 30 days compared to emergency hip fracture surgery. The severity of injury and high rates of mortality associated with emergency spine fracture surgery should be used by clinicians to guide patients and their families when making choices, the authors said.

“The data suggests that elderly patients may have a greater risk of mortality after undergoing surgery for emergent spine fractures versus if they were to have emergent hip fractures in the short term postoperatively,” the authors said.