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Predicting survival in older patients treated for cervical spine fractures: Development of a clinical survival score

The Spine Journal May 24, 2019

Cronin PK, et al. - From two tertiary care centers (2009-2016), retrospective review of records of patients age 50 and older who received operative or non-operative management for cervical fractures was done to develop an accessible and intuitive predictive model for survival in these individuals. Among the included 1,758 patients, they noted mortality rates of 12% at 3-months, 17% at 1-year and 21% at 2-years. Age, Injury Severity Score and Glasgow Coma Scale were noted to have the strongest predictive values for a base score, followed by serum albumin and ambulatory status in multivariable testing. The resultant composite score that ranged from 0 (base score≤4, albumin≤3.5g/dL and dependent/non-ambulator at presentation) to a maximum of 4 (base score≥5, albumin>3.5g/dL and independent ambulator at presentation) had a useful prognostic utility in assessing survival in these individuals. Findings suggest the applicability of the score in adjusting patient expectations, anticipating outcomes and as an adjunct to decision making in the post-injury period.
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