This study aimed to investigate the instantaneous death risk and conditional survival (CS) in patients with AS and cervical fracture. We also studied the relationship between surgical timing and the incidence of complications.
This national multicentre retrospective study included 459 patients with AS and cervical fractures between 2003 and 2019. The hazard function was used to determine the risk of instantaneous death. The five-year CS was calculated to show the dynamic changes in prognosis.
The instantaneous death risk was relatively high in the first 6 months and gradually decreased over time in patients with AS and cervical fracture. For patients who did not undergo surgery, the instantaneous risk of death was relatively high in the first 15 months and gradually decreased over time. For patients with American Spinal Injury Association impairment scale (ASIA) A and B, the 5-year CS was 55.3% at baseline, and improved steadily to 88.4% at 2 years. Odds ratios (ORs) for pneumonia, electrolyte disturbance, respiratory insufficiency, and phlebothrombosis decreased as the surgery timing increased.
Deaths occurred mainly in the first 6 months after injury and gradually decreased over time. Our study highlights the need for continued surveillance and care in patients with AS with cervical fractures and provides useful survival estimates for both surgeons and patients. We also observed that early surgery can significantly increase functional recovery, and decrease the incidence of complications and rehospitalisation.
本研究旨在调查AS和颈椎骨折患者的瞬时死亡风险和条件生存(CS)。我们还研究了手术时机与并发症发生率之间的关系。
这项国家多中心回顾性研究包括2003年至2019年之间的459例AS和颈椎骨折患者。危险函数用于确定瞬时死亡的风险。计算五年CS以显示预后的动态变化。
AS和颈椎骨折患者的瞬时死亡风险在前6个月相对较高,随着时间的推移逐渐降低。对于没有接受手术的患者,在前15个月,瞬时死亡风险相对较高,并随着时间逐渐下降.对于美国脊髓损伤协会损害量表(ASIA)A和B的患者,基线时,5年CS为55.3%,并在2年内稳步提高至88.4%。肺炎的赔率(OR),电解质扰动,呼吸功能不全,静脉血栓形成随着手术时机的增加而减少。
死亡主要发生在受伤后的前6个月,并随着时间的推移逐渐减少。我们的研究强调了对AS伴颈椎骨折患者进行持续监测和护理的必要性,并为外科医生和患者提供了有用的生存估计。我们还观察到,早期手术可以显着增加功能恢复,并降低并发症和再住院的发生率。