Association of impaired levels with outcomes for cervical fracture dislocation using the Japanese diagnosis procedure combination database

Study Design: Retrospective study of data abstracted from the diagnosis procedure combination (DPC) database. Objecitives: The etiology of cervical fracture dislocation (CFD) remains unknown because of the limited clinical investigations that involve approximately 100 individuals. This study investi...

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Main Authors: Kazuma Doi, Naoki Otani, Norihiko Inoue, Junichi Mizuno, Kiyohide Fushimi, Atsuo Yoshino
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2024-12-01
Series:Journal of Craniovertebral Junction and Spine
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Online Access:https://journals.lww.com/10.4103/jcvjs.jcvjs_127_24
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author Kazuma Doi
Naoki Otani
Norihiko Inoue
Junichi Mizuno
Kiyohide Fushimi
Atsuo Yoshino
author_facet Kazuma Doi
Naoki Otani
Norihiko Inoue
Junichi Mizuno
Kiyohide Fushimi
Atsuo Yoshino
author_sort Kazuma Doi
collection DOAJ
description Study Design: Retrospective study of data abstracted from the diagnosis procedure combination (DPC) database. Objecitives: The etiology of cervical fracture dislocation (CFD) remains unknown because of the limited clinical investigations that involve approximately 100 individuals. This study investigated the association of CFD-impaired levels with patient outcomes. Methods: This study included 4653 adult patients with a definitive CFD diagnosis from the DPC database. The database consisted of nationwide inpatient data collected from >1000 acute care hospitals in Japan. This DPC database contains information regarding the hospitalization course, such as diagnosis, treatment, medical history, complications, and hospitalization outcomes. We included 866 CFD patients whose impaired levels were specified. We compared the outcomes between the patients whose CFD occurred in the upper cervical levels (“high” group) and the intermediate-low levels (“low” group). This study determined 121 pairs of patients after one-to-one propensity score matching (PSM). The main outcomes included inhospital death, 30-day mortality, and major complications after admission. The secondary outcomes were the length of hospital stay, discharged home rate, and improvement in Barthel index. Results: No differences in inhospital death and 30-day mortality were found between the high and low groups, even after adjusting for PSM (P > 0.05, respectively). Moreover, this analysis revealed that the high group exhibited a higher incidence of respiratory complications than the low group (37.2% vs. 24.8%; P = 0.0256). Conclusions: This study revealed no difference in mortality but a significantly higher incidence of respiratory complications with high-level CFD compared to low-level CFD.
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spelling doaj-art-81cc5934be6f4102bb633a223f58651f2025-02-06T06:11:06ZengWolters Kluwer Medknow PublicationsJournal of Craniovertebral Junction and Spine0974-82370976-92852024-12-0115443343610.4103/jcvjs.jcvjs_127_24Association of impaired levels with outcomes for cervical fracture dislocation using the Japanese diagnosis procedure combination databaseKazuma DoiNaoki OtaniNorihiko InoueJunichi MizunoKiyohide FushimiAtsuo YoshinoStudy Design: Retrospective study of data abstracted from the diagnosis procedure combination (DPC) database. Objecitives: The etiology of cervical fracture dislocation (CFD) remains unknown because of the limited clinical investigations that involve approximately 100 individuals. This study investigated the association of CFD-impaired levels with patient outcomes. Methods: This study included 4653 adult patients with a definitive CFD diagnosis from the DPC database. The database consisted of nationwide inpatient data collected from >1000 acute care hospitals in Japan. This DPC database contains information regarding the hospitalization course, such as diagnosis, treatment, medical history, complications, and hospitalization outcomes. We included 866 CFD patients whose impaired levels were specified. We compared the outcomes between the patients whose CFD occurred in the upper cervical levels (“high” group) and the intermediate-low levels (“low” group). This study determined 121 pairs of patients after one-to-one propensity score matching (PSM). The main outcomes included inhospital death, 30-day mortality, and major complications after admission. The secondary outcomes were the length of hospital stay, discharged home rate, and improvement in Barthel index. Results: No differences in inhospital death and 30-day mortality were found between the high and low groups, even after adjusting for PSM (P > 0.05, respectively). Moreover, this analysis revealed that the high group exhibited a higher incidence of respiratory complications than the low group (37.2% vs. 24.8%; P = 0.0256). Conclusions: This study revealed no difference in mortality but a significantly higher incidence of respiratory complications with high-level CFD compared to low-level CFD.https://journals.lww.com/10.4103/jcvjs.jcvjs_127_24cervical fracture dislocationdatabasediagnosis procedure combinationrespiratory complications
spellingShingle Kazuma Doi
Naoki Otani
Norihiko Inoue
Junichi Mizuno
Kiyohide Fushimi
Atsuo Yoshino
Association of impaired levels with outcomes for cervical fracture dislocation using the Japanese diagnosis procedure combination database
Journal of Craniovertebral Junction and Spine
cervical fracture dislocation
database
diagnosis procedure combination
respiratory complications
title Association of impaired levels with outcomes for cervical fracture dislocation using the Japanese diagnosis procedure combination database
title_full Association of impaired levels with outcomes for cervical fracture dislocation using the Japanese diagnosis procedure combination database
title_fullStr Association of impaired levels with outcomes for cervical fracture dislocation using the Japanese diagnosis procedure combination database
title_full_unstemmed Association of impaired levels with outcomes for cervical fracture dislocation using the Japanese diagnosis procedure combination database
title_short Association of impaired levels with outcomes for cervical fracture dislocation using the Japanese diagnosis procedure combination database
title_sort association of impaired levels with outcomes for cervical fracture dislocation using the japanese diagnosis procedure combination database
topic cervical fracture dislocation
database
diagnosis procedure combination
respiratory complications
url https://journals.lww.com/10.4103/jcvjs.jcvjs_127_24
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