期刊
AMERICAN JOURNAL OF EMERGENCY MEDICINE
卷 67, 期 -, 页码 144-155出版社
W B SAUNDERS CO-ELSEVIER INC
DOI: 10.1016/j.ajem.2023.02.008
关键词
Spinal fractures; Aged; Falls; Diagnostic imaging
This systematic review found that adults aged 65 and older are at risk of cervical spine injury after low-level falls, and explored the association between unreliable clinical exam and C-spine injury. A meta-analysis of 21 studies revealed a prevalence rate of 3.8% for C-spine injury in this population. More research is needed to determine whether there is an association between GCS < 15 or altered level of consciousness and cervical spine injury.
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 as-sociation 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, ab-stracted 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 unre-liable clinical exam. Results: The search identified 2044citations, 138 full texts were screened, and 21 studies were included in the sys-tematic 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. (c) 2023 Elsevier Inc. All rights reserved.
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