Chia Wei Tan1*, Ahmad Tarawneh2, Khalid Salem2 and Opinder Sahota1,2
1Department of Health Care of Older Persons, Queens Medical Centre, Nottingham University Hospitals, UK
2Department of Spinal Surgery, Queens Medical Centre, Nottingham University Hospitals, UK
Older patients undergoing spinal surgery are at an increased risk of perioperative complications, prolonged hospitalization and mortality due to underlying co-morbidities. Our aim was to investigate the incidence of older patients (aged 70 years and over) presenting to the regional Spinal unit (catchment population of 4.5 million) over a 30 month period. Patient demographics, comorbidities, cause of referral, treatment modality (conservative vs. surgical), length of hospital stay, discharge destination (home vs. rehabilitation) and mortality rates were collected and analyzed. A total of 677 (Male: 335, Female: 342) older patients presented to the unit. The mean age at presentation was 82.3 (± 7.48) years. Spinal trauma was the most common reason for inpatient referrals (n=448; 66.2%). Low trauma (insufficiency) fractures contributed to more than half of the total trauma referrals (n=256). Spondylodiscitis was the least common cause of referral (n=34; 5%). 545 patients were treated conservatively (80.5%). Average length of stay was 16.7 days (± 19.9). 81 of the discharged patients (13.5%) were transferred to rehabilitation after discharge, and the over-all 30-day mortality rate was 11.5% (n=78). An ageing population represented a significant proportion of admissions, with protracted length of stay despite a majority being managed conservatively (nonsurgically).
Tan CW, Tarawneh A, Salem K, Sahota O. Incidence of Older People Presenting Acutely to a Regional Spine Unit. Clin Surg. 2021; 6: 3285.