Authors: Mahla Radmard, Armin Tafazolimoghadam, Meisam Hoseinyazdi, Mona Shahriari, Javad R Azadi, Arjun Chanmugam, David M Yousem
Published in: Academic Emergency Medicine, June 29, 2024
Conclusions: The findings suggest a relatively low incidence of cervical spine fractures among older trauma patients, particularly those between 65 and 70 years old. The minimal risk of missed fractures in asymptomatic patients within this age range (0.18%) indicates that routine CSCT may not be warranted solely based on age. The study advocates for a more nuanced approach to CSCT screening in this population, potentially incorporating shared decision-making to optimize care and resource use.
Methods: The study reviewed CSCT reports from two hospitals from 2018 to 2023. Patients aged 65 and older were the focus, and data on fracture types, sites, and treatments were analyzed. Patients were categorized as symptomatic or asymptomatic, with statistical tests comparing fracture rates across age groups and symptoms.
Results: Among 9,455 patients aged 65 or older who underwent CSCT, 192 (2.0%) had fractures, including 28 (0.30%) asymptomatic individuals. Fracture rates were notably lower in the 65-70 age group compared to older cohorts. There was no significant difference in the nature or treatment of fractures between symptomatic and asymptomatic patients.
Radmard, M., Tafazolimoghadam, A., Hoseinyazdi, M., Shahriari, M., Azadi, J.R., Chanmugam, A. and Yousem, D.M., 2024. Is older age an appropriate criterion alone for ordering cervical spine computed tomography after trauma. Academic Emergency Medicine.