Association of Mortality and Charlson Comorbidity Index in Surgical Spinal Trauma Patients at a Level I Academic Center

Abstract

Objectives:The Charlson Comorbidity Index score (CCI) records the presence of comorbidities with various weights for a total score to estimate mortality within 1 year of hospital admission. Our study sought to assess the association of CCI with mortality rates of patients undergoing surgical intervention. Study Design: Retrospective study. Methods: Retrospective study of patients with surgical spinal trauma at a large academic level I trauma tertiary center from 2015 to 2018. Information collected included age, sex, American Society of Anesthesiologists physical status, body mass index, Charlson comorbidities, injury severity score, the presence of spinal cord injury, and mortality. Mortality was measured at 30 days, 90 days, and 1 year. Descriptive and bivariate analyses were completed. The results were significant at P , 0.05. Results: The highest proportion of 1-year mortality was in the patients with cervical (11.3%) and thoracolumbar injuries (7.4%) (P = 0.002). Patients with low CCI had low 1-year mortality (1.7%). Patients with high CCI had high 1-year mortality (13.8%) (P , 0.001). A significant association existed between CCI and mortality at 30 days, 90 days, and 1 year (P , 0.001). Mortality was higher in patients with spinal cord injury (14/108; 13%) than in those without (11/232; 5%) (P = 0.021). No association existed between ISS and mortality (P = 0.26). Discussion: The CCI was associated with a higher proportion of deaths at 30 days, 90 days, and 1 year. This association may help predict this unfortunate complication and guide the surgical team in formulating treatment plans and counseling patients and families regarding mortality associated with these injuries and the risks of surgical intervention.A traumatic spinal injury is a broad term that encompasses a range of injuries such as vertebral body fractures, fracture dislocations, ligamentous disruptions, facet joint injuries, spinal cord injuries, and other

Epidemiology of Cervical Fracture/Cervical Spinal Cord Injury and Changes in Surgical Treatment Modalities in Elderly Individuals During a 10-year Period: A Nationwide Multicenter Study in Japan

“…Results showed that the 30-days mortality rate of cervical spine injuries was 7.3%. 20 However, the current study showed that the mortality rate was only 3.3% (not limited to within 1 month) in elderly patients. Although 2 patients (.29%) died due to surgery, they were well within the acceptable risk range for the surgical treatment of elderly patients with CF and/or CSCI.…”

Attempted Suicide Is Independently Associated with Increased In-Hospital Mortality and Hospital Length of Stay among Injured Patients at Community Tertiary Hospital in Japan: A Retrospective Study with Propensity Score Matching Analysis

“…The ISS and AIS are widely used anatomical scoring systems that are correlated with trauma mortality and morbidity [11][12][13]. A high Charlson Comorbidity Index was also known to be associated with increased mortality in patients with trauma [23,24]. Therefore, these variables were incorporated into the logistic regression model to find the PS.…”

A Predictive Model to Identify Treatment-related Risk Factors for Odontoid Fracture Nonunion Using Machine Learning

“…low-energy trauma). The presence and severity of comorbidities were assessed using the Charlson comorbidity index (CCI) 14. The type of treatment was recorded, which included conservative management, anterior screw fixation using one or two screws, posterior C1/C2 spondylodesis, and C0–C4 fusion.…”

“…The presence and severity of comorbidities were assessed using the Charlson comorbidity index (CCI). 14 The type of treatment was recorded, which included conservative management, anterior screw fixation using one or two screws, posterior C1/C2 spondylodesis, and C0-C4 fusion. In the group with posterior C1/C2 spondylodesis, the majority of patients were treated with the method according to Magerl, 15,16 and few underwent screw fixation according to Harms.…”