Gender Disparities in Surgical Treatment of Axis Fractures in Older Adults

Public Deposited
Analytics

Downloadable Content

Download PDF
Request Version for Screen Reader
Creator
  • Catalino, Michael P.
  • Kessler, Brice A.
  • Pate, Virginia
    • Affiliation: University of North Carolina at Chapel Hill
  • Cutshaw, Drew
    • Affiliation: University of North Carolina at Chapel Hill
  • Stürmer, Til
    • Affiliation: University of North Carolina at Chapel Hill
  • Bhowmick, Deb A.
    • Affiliation: University of North Carolina at Chapel Hill
Abstract
  • Study Design: Retrospective cohort study. Objectives: Gender appears to play in important role in surgical outcomes following acute cervical spine trauma, with current literature suggesting males have a significantly higher mortality following spine surgery. However, no well-adjusted population-based studies of gender disparities in incidence and outcomes of spine surgery following acute traumatic axis injuries exist to our knowledge. We hypothesized that females would receive surgery less often than males, but males would have a higher 1-year mortality following isolated traumatic axis fractures. Methods: We performed a retrospective cohort study using Medicare claims data that identified US citizens aged 65 and older with ICD-9 (International Classification of Diseases, Ninth Revision) code diagnosis corresponding to isolated acute traumatic axis fracture between 2007 and 2014. Our primary outcome was defined as cumulative incidence of surgical treatment, and our secondary outcome was 1-year mortality. Propensity weighted analysis was performed to balance covariates between genders. Our institutional review board approved the study (IRB #16-0533). Results: There was no difference in incidence of surgery between males and females following acute isolated traumatic axis fractures (7.4 and 7.5 per 100 fractures, respectively). Males had significantly higher 1-year weighted mortality overall (41.7 and 28.9 per 100 fractures, respectively, P < .001). Conclusion: Our well-adjusted data suggest there was no significant gender disparity in incidence of surgical treatment over the study period. The data also support previous observations that males have worse outcomes in comparison to females in the setting of axis fractures and spinal trauma regardless of surgical intervention.
Date of publication
Keyword
DOI
Identifier
Resource type
  • Article
Rights statement
  • In Copyright
Rights holder
  • AO Spine, unless otherwise noted. Manuscript content on this site is licensed under Creative Commons Licenses
License
  • Attribution-NonCommercial-NoDerivatives 4.0 International
Journal title
  • Global Spine Journal
Journal volume
  • 11
Journal issue
  • 1
Page start
  • 71
Page end
  • 75
ISSN
  • 2192-5682
  • 2192-5690
Copyright date
  • 2019
Publisher
  • SAGE Publications

Relations

Parents:

This work has no parents.

In Collection:

Items

Thumbnail Title Date Uploaded Visibility Actions
file details 10.1177_2192568219890573.pdf 2022-02-02 Public Download