Delirium Risk Score in Elderly Patients with Cervical Spinal Cord Injury and/or Cervical Fracture

Area of Science:

• Gerontology
• Neuroscience
• Trauma Surgery

Background:

• Elderly patients with cervical trauma face a high risk of delirium.
• Delirium is an acute neuropsychological disorder impacting cognitive function and environmental interaction.

Purpose of the Study:

• To develop a predictive risk score for delirium in elderly patients with cervical spinal cord injury (SCI) and/or cervical fracture.
• To create a tool applicable regardless of surgical or conservative treatment strategies.

Main Methods:

• Retrospective cohort study of 1512 patients aged 65 years and older with cervical SCI and/or fracture.
• Multivariate logistic regression analysis to identify delirium risk factors.
• Development of a simple arithmetic risk score based on significant variables.

Main Results:

• A six-factor delirium risk score was established: advanced age (≥80 years), hypoalbuminemia, cervical fracture, major organ injury, pre-injury mobility dependence, and comorbid diabetes.
• The risk score demonstrated an area under the curve of 0.66 (p < 0.001) for delirium prediction.
• Significant risk factors were identified irrespective of treatment type (surgical vs. conservative).

Conclusions:

• The developed delirium risk score aids in identifying elderly patients with cervical trauma at high risk.
• This score can be utilized during initial hospitalization screening to inform treatment decisions.
• Further validation with independent datasets is recommended for clinical implementation.