Epidemiology and Clinical Outcomes of Vertebral Fractures in Older Adults: A Three-Year Study from Northwestern Iran

Abstract

Objective: This study aimed to determine the epidemiological characteristics of elderly patients hospitalized for spinal fractures at Mousavi Referral Hospital in Zanjan, Iran, from 2021 to 2023. Methods: In this cross-sectional study, medical records of 261 elderly patients hospitalized with vertebral fractures were reviewed. Data on demographic characteristics, injury mechanisms, vertebral involvement, associated injuries, spinal cord damage, and patient outcomes were extracted and analyzed. Results: Of the 261 patients, 138 (52.9%) were men and 123 (47.1%) were women. The mean age was 70.4±8.37 (range: 60-95). Women were significantly older than men (70±11 vs. 67±11, p=0.03). Male patients sustained a significantly higher number of fractured vertebrae than females (p=0.02). The incidence of fractures varied significantly across seasons (p=0.001). The most common fracture site was the thoracolumbar junction (56.2%), and the main cause was falling (58.6%). Spinal cord injuries occurred in 7.3% of patients. The most frequent associated fractures were pelvic (25.9%). The length of hospital stay increased significantly with the presence of associated fractures (p=0.001), spinal cord injuries (p=0.02), and a greater number of fractured vertebrae (p=0.04). Conclusion: Elderly spinal fracture patients, particularly men and those with multiple vertebral fractures, are at an increased risk of spinal cord injury, associated fractures, prolonged hospitalization, and mortality. Falls remain the most frequent cause, and the thoracolumbar junction the most common site. These findings highlighted the need for targeted prevention strategies, cautious clinical management, and early identification of high-risk patients to improve outcomes.