Retrospective epidemiological study on cervical fracture dislocation in adolescents using the Diagnosis Procedure Combination database in Japan.

STUDY

DESIGN

This was a retrospective study using the Diagnosis Procedure Combination (DPC) database.

PURPOSE: Using a large national database, we aimed to investigate the epidemiology, treatment patterns, and outcomes of cervical fracture dislocation (CFD) among adolescents.

OVERVIEW OF LITERATURE: There have been numerous clinical studies on CFD in adults. However, the current lack of studies on adolescent CFD is a clinically relevant research gap that urgently needs to be addressed.

METHODS

Among 4,653 inpatients who were identified to have a definitive diagnosis of CFD from 2010 to 2021 from the DPC database, we extracted the medical data of 84 adolescent inpatients (aged 11-18 years).

RESULTS

CFD in adolescent inpatients was rare, accounting for only 1.8% of all patients with CFD in the DPC database. Complications occurred in 31 patients (36.9%), and mortality rate was 9.5%. Of eight patients who died, four were complicated by traumatic brain injury. Polytrauma was found in 32 patients (38.1%), and its incidence was significantly higher in those with mental disorders (p <0.001). The proportion of patients who were discharged home was significantly lower in those with mental disorders than in those without mental disorders (p =0.01).

CONCLUSIONS

This epidemiological study provided new insights into adolescent CFD using real-world data. Future research should focus on the evaluation of long-term functional prognosis and development of preventive strategies and improved treatments for CFD in adolescent patients.