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Martínez-Velilla N, Tarazona-Santabalbina FJ. [Departments of Geriatric Medicine: From evidence to actual implementation in Spain]. Rev Esp Geriatr Gerontol 2022; 57:201-202. [PMID: 36028451 DOI: 10.1016/j.regg.2022.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Accepted: 07/18/2022] [Indexed: 10/15/2022]
Affiliation(s)
- Nicolás Martínez-Velilla
- Servicio de Geriatría, Hospital Universitario de Navarra, Navarrabiomed, Universidad Pública de Navarra (UPNA), IdiSNA, Pamplona, Navarra, España; Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES), Instituto de Salud Carlos III, Madrid, España.
| | - Francisco José Tarazona-Santabalbina
- Servicio de Geriatría, Hospital Universitario de La Ribera, Alzira, Valencia, España; Escuela de Doctorado, Universidad Católica de Valencia San Vicente Mártir, Valencia, España
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Cooper Z, Mitchell SL, Lipsitz S, Harris MB, Ayanian JZ, Bernacki RE, Jha AK. Mortality and Readmission After Cervical Fracture from a Fall in Older Adults: Comparison with Hip Fracture Using National Medicare Data. J Am Geriatr Soc 2015; 63:2036-42. [PMID: 26456855 DOI: 10.1111/jgs.13670] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
OBJECTIVES To examine the prevalence of cervical spine fractures after falls in older Americans, to show changes in recent years, and to compare 12-month outcomes between individuals with cervical and hip fracture after falls. DESIGN Retrospective study of Medicare data from 2007 to 2011. SETTING Acute care hospitals. PARTICIPANTS Individuals aged 65 and older with cervical or hip fracture after a fall. MEASUREMENTS Cervical fracture rate, 12-month mortality, and readmission rate after injury. RESULTS Rates of cervical fracture increased from 4.6 per 10,000 in 2007 to 5.3 per 10,000 in 2011; rates of hip fracture decreased from 77.3 per 10,000 in 2007 to 63.5 per 10,000 in 2011. Participants with cervical fracture with and without spinal cord injury (SCI) were more likely than those with hip fracture to receive treatment at large hospitals (59.4% and 54.1% vs 28.1%, P < .001), teaching hospitals (49.3% and 40.0% vs 13.4%, P < .001), and regional trauma centers (46.3% and 38.5% vs 13.0%, P < .001). Participants with cervical fracture without (24.7%) and with SCI (41.7%) had greater risk-adjusted mortality at 1 year than those with hip fracture (22.7%) (P < .001). By 1 year, 73.4% of participants with cervical fracture with and 59.5% without SCI and 59.3% of those with hip fracture had died or were readmitted to the hospital (P < .001). CONCLUSION Cervical spinal fractures occur in one of every 2,000 Medicare beneficiaries annually and appear to be increasing over time. Participants with cervical fracture had greater mortality than those with hip fracture. Given the increasing prevalence and the poor outcomes in this population, hospitals need to develop processes to improve care for these vulnerable individuals.
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Affiliation(s)
- Zara Cooper
- Division of Trauma, Burns and Surgical Critical Care, Brigham and Women's Hospital, Boston, Massachusetts.,Center for Surgery and Public Health, Brigham and Women's Hospital, Boston, Massachusetts.,Medical School of Medicine, Harvard University, Boston, Massachusetts
| | - Susan L Mitchell
- Medical School of Medicine, Harvard University, Boston, Massachusetts.,Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts.,Institute for Aging Research, Hebrew SeniorLife, Boston, Massachusetts
| | - Stuart Lipsitz
- Center for Surgery and Public Health, Brigham and Women's Hospital, Boston, Massachusetts.,Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Mitchel B Harris
- Medical School of Medicine, Harvard University, Boston, Massachusetts.,Department of Orthopedic Surgery, Brigham and Women's Hospital, Boston, Massachusetts
| | - John Z Ayanian
- Division of General Medicine, University of Michigan, Ann Arbor, Michigan.,Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, Michigan
| | - Rachelle E Bernacki
- Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, Massachusetts.,Ariadne Labs, Boston, Massachusetts
| | - Ashish K Jha
- T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts
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