Cervical spine injuries in adults ≥ 65 years after low-level falls – A systematic review and meta-analysis - 20/04/23
, Debra Eagles, MD, MSc a, c , Yongdong Ouyang, PhD a, d , Jamie Vander Ende e , Christian Vaillancourt, MD, MSc a, c , Christophe Fehlmann, MD a, f , Risa Shorr g , Monica Taljaard, PhD a, d , Ian Stiell, MD, MSc a, c Abstract |
Background |
Adults ≥ 65 are at risk of cervical spine (C-spine) injury, even after low-level falls. The objectives of this systematic review were to determine the prevalence of C-spine injury in this population and explore the association of unreliable clinical exam with C-spine injury.
Methods |
We conducted this systematic review according to PRISMA guidelines. We searched MEDLINE, PubMed, EMBASE, Scopus, Web of Science, and the Cochrane Database of Systematic reviews to include studies reporting on C-spine injury in adults ≥ 65 years after low-level falls. Two reviewers independently screened articles, abstracted data, and assessed bias. Discrepancies were resolved by a third reviewer. A meta-analysis was performed to estimate overall prevalence and the pooled odds ratio for the association between C-spine injury and an unreliable clinical exam.
Results |
The search identified 2044citations, 138 full texts were screened, and 21 studies were included in the systematic review. C-spine injury prevalence in adults ≥ 65 years after low-level falls was 3.8% (95% CI: 2.8–5.3). The odds of c-spine injury in those with altered level of consciousness (aLOC) v/s not aLOC was 1.21 (0.90–1.63) and in those with GCS < 15 v/s GCS 15 was 1.62 (0.37–6.98). Studies were at a low-risk of bias, although some had low recruitment and significant loss to follow-up.
Conclusions |
Adults ≥ 65 years are at risk of cervical spine injury after low-level falls. More research is needed to determine whether there is an association between cervical spine injury and GCS < 15 or altered level of consciousness.
Le texte complet de cet article est disponible en PDF.Keywords : Spinal fractures, Aged, Falls, Diagnostic imaging
Plan
Vol 67
P. 144-155 - mai 2023 Retour au numéro
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