AB092. SOH24AB_159. Comparative outcomes of early vs. delayed surgical intervention in geriatric patients with spinal fractures and concomitant spinal cord injuries
Orthopaedic Session I

AB092. SOH24AB_159. Comparative outcomes of early vs. delayed surgical intervention in geriatric patients with spinal fractures and concomitant spinal cord injuries

Arnav Barve1, Harry Marland2, Jake McDonnell3, Kielan Wilson1, Julie Wall2, Stacey Darwish4, Joseph Butler2

1School of Medicine, University College Dublin, Belfield, Dublin, Ireland; 2National Spinal Injuries Unit, Mater Misericordiae University Hospital, Dublin, Ireland; 3Trinity Centre of Biomedical Engineering, Trinity College Dublin, Dublin, Ireland; 4Department of Orthopaedics, St. Vincent’s University Hospital, Dublin, Ireland

Background: The elderly population have high rates of morbidity and mortality following traumatic spinal cord injuries (SCIs) but are also at increased risk of intraoperative and postoperative complications. This makes treatment decision-making less clear and more challenging in this cohort compared to younger patients with similar injuries.

Methods: A retrospective review was carried out at our centre from 2016–2020 to identify geriatric patients (≥65 years old) presenting with a traumatic SCI, managed surgically. Cohorts were categorised and compared for outcomes based on their time from injury to surgery. The different time intervals assessed include: 24 and 72 hours.

Results: A total of 72 patients were identified. Thirteen/72 (18.1%) underwent surgery within 24 hours of their injury. Mean age of the entire cohort was 75.3 years, of which 47/72 (65%) were males. For the 24-hour time interval, there was a difference in intraoperative complications (4/13 vs. 7/59; P=0.043), postoperative complications (10/13 vs. 27/59; P=0.021), patients requiring high dependency unit (HDU) (8/13 vs. 14/59; P=0.004), patients requiring intensive care unit (ICU) (8/13 vs. 12/59; P=0.001) and overall mean length-of-stay (46.8 vs. 18.0; P=0.01). No difference existed for postoperative neurological improvement (3/13 vs. 27/59; P=0.067) or deterioration (2/13 vs. 7/59; P=0.363), revision surgeries (1/13 vs. 7/59; P=0.334) and 30-day mortality (0/13 vs. 6/59; P=0.115).

Conclusions: This is the first study, to the authors best knowledge, that compares surgical outcomes in geriatric patients presenting with traumatic SCI depending on their injury to surgery time interval. Although limited by its retrospective design and sample size, this study highlights the potential benefit of delaying surgical intervention in this cohort.

Keywords: Geriatric; injury-to-surgery time; outcomes; spinal cord injury (SCI); surgical management

Acknowledgments

Funding: None.

Footnote

Conflicts of Interest: The authors have no conflicts of interest to declare.

Ethical Statement: The authors are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0/.

doi: 10.21037/map-24-ab092
Cite this abstract as: Barve A, Marland H, McDonnell J, Wilson K, Wall J, Darwish S, Butler J. AB092. SOH24AB_159. Comparative outcomes of early vs. delayed surgical intervention in geriatric patients with spinal fractures and concomitant spinal cord injuries. Mesentery Peritoneum 2024;8:AB092.

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