Variations in treatment of C1 fractures by time, age, and geographic region in the United States: An analysis of 985 patients

The purpose of this investigation was to evaluate the variations in the treatment of C1 fractures over time, by age group, and by geographic region using a nationwide database. The Nationwide Emergency Department Sample (NEDS) database was queried to identify patients ≥18 years who sustained C1 fra...

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Main Authors: Sheyan J. Armaghani, Zachary J. Grabel, Catphuong Vu, S. Tim Yoon
Format: Article
Language:English
Published: Open Medical Publishing 2018-12-01
Series:Orthopedic Reviews
Subjects:
Online Access:https://www.pagepress.org/journals/index.php/or/article/view/7834
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spelling doaj-96894343f5fd42a2b5fe2a15dd1bcd712021-05-02T18:41:52ZengOpen Medical PublishingOrthopedic Reviews2035-82372035-81642018-12-0110410.4081/or.2018.7834Variations in treatment of C1 fractures by time, age, and geographic region in the United States: An analysis of 985 patientsSheyan J. Armaghani0Zachary J. Grabel1Catphuong Vu2S. Tim Yoon3Florida Orthopedic Institute, Temple Terrace, FLDepartment of Orthopedic Surgery, Emory University School of Medicine, Atlanta, GADepartment of Orthopedics and Sports Medicine, University of Washington, Seattle, WADepartment of Orthopedic Surgery, Emory University School of Medicine, Atlanta, GA The purpose of this investigation was to evaluate the variations in the treatment of C1 fractures over time, by age group, and by geographic region using a nationwide database. The Nationwide Emergency Department Sample (NEDS) database was queried to identify patients ≥18 years who sustained C1 fracture from 2006-2012. Patients were filtered based on the intervention they received: collar, halo, or surgery. Regions of hospital used in analysis were defined as Northeast, Midwest, South, and West. Surgical intervention for C1 fracture increased from 27.1% of cases in 2006 to 55.4% of cases in 2012 (P<0.001). The rate of collar treatment increased with increasing age. In contrast, rate of halo use decreased with increasing age. A greater proportion of patients in the Northeast were treated by collar compared to all other regions (P<0.001). We can conclude that there is considerable variation in the treatment of C1 fractures with regards to age and geographic region. Surgical treatment of these fractures is increasing over time. Future considerations should be given to developing treatment guidelines to decrease variation and potentially create cost-savings. https://www.pagepress.org/journals/index.php/or/article/view/7834C1 fracture, treatment variations, halo, cervical collar.
collection DOAJ
language English
format Article
sources DOAJ
author Sheyan J. Armaghani
Zachary J. Grabel
Catphuong Vu
S. Tim Yoon
spellingShingle Sheyan J. Armaghani
Zachary J. Grabel
Catphuong Vu
S. Tim Yoon
Variations in treatment of C1 fractures by time, age, and geographic region in the United States: An analysis of 985 patients
Orthopedic Reviews
C1 fracture, treatment variations, halo, cervical collar.
author_facet Sheyan J. Armaghani
Zachary J. Grabel
Catphuong Vu
S. Tim Yoon
author_sort Sheyan J. Armaghani
title Variations in treatment of C1 fractures by time, age, and geographic region in the United States: An analysis of 985 patients
title_short Variations in treatment of C1 fractures by time, age, and geographic region in the United States: An analysis of 985 patients
title_full Variations in treatment of C1 fractures by time, age, and geographic region in the United States: An analysis of 985 patients
title_fullStr Variations in treatment of C1 fractures by time, age, and geographic region in the United States: An analysis of 985 patients
title_full_unstemmed Variations in treatment of C1 fractures by time, age, and geographic region in the United States: An analysis of 985 patients
title_sort variations in treatment of c1 fractures by time, age, and geographic region in the united states: an analysis of 985 patients
publisher Open Medical Publishing
series Orthopedic Reviews
issn 2035-8237
2035-8164
publishDate 2018-12-01
description The purpose of this investigation was to evaluate the variations in the treatment of C1 fractures over time, by age group, and by geographic region using a nationwide database. The Nationwide Emergency Department Sample (NEDS) database was queried to identify patients ≥18 years who sustained C1 fracture from 2006-2012. Patients were filtered based on the intervention they received: collar, halo, or surgery. Regions of hospital used in analysis were defined as Northeast, Midwest, South, and West. Surgical intervention for C1 fracture increased from 27.1% of cases in 2006 to 55.4% of cases in 2012 (P<0.001). The rate of collar treatment increased with increasing age. In contrast, rate of halo use decreased with increasing age. A greater proportion of patients in the Northeast were treated by collar compared to all other regions (P<0.001). We can conclude that there is considerable variation in the treatment of C1 fractures with regards to age and geographic region. Surgical treatment of these fractures is increasing over time. Future considerations should be given to developing treatment guidelines to decrease variation and potentially create cost-savings.
topic C1 fracture, treatment variations, halo, cervical collar.
url https://www.pagepress.org/journals/index.php/or/article/view/7834
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