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

Abstract

This was a retrospective study using the Diagnosis Procedure Combination (DPC) database. Using a large national database, we aimed to investigate the epidemiology, treatment patterns, and outcomes of cervical fracture dislocation (CFD) among adolescents. 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. 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). 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). 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.