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Differences in comorbidities and concomitant diseases\u00a0and injuries were analyzed using the Chi-square test. In surgically treated patients, odds ratios (OR) with 95% confidence intervals (95%\u00a0CI) were used to analyze potential risk factors for in-hospital mortality.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Among 10,077 patients, the in-hospital mortality rate was 8.4%, with no significant difference between surgically (9.4%) and non-surgically treated patients (7.9%; <jats:italic>p<\/jats:italic>\u2009=\u20090.103). The most common comorbidities were essential hypertension (67.3%), atrial fibrillation (28.2%), and chronic kidney disease (23.3%), while the most common concomitant injuries were head and face wounds (25.9%), concussions (12.8%), and\u00a0atlas fractures (11.6%). In surgically treated patients, spinal cord injury (OR\u2009=\u20094.62, 95% CI: 2.23\u20139.58), acute renal failure (OR\u2009=\u20093.20, 95% CI: 2.26\u20134.53), and acute bleeding anemia (OR\u2009=\u20092.06, 95% CI: 1.64\u20132.59) were associated with increased in-hospital mortality (all <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.01). Screw-rod-system fixation\u00a0of one segment (OR\u2009=\u20090.74, 95% CI: 0.56\u20130.97) and intraoperative navigation (OR\u2009=\u20090.45, 95% CI: 0.16\u20130.71) were identified as potential protective factors\u00a0(both <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>Comprehensive geriatric assessment and optimization of comorbidities during treatment are crucial. The indication for surgical treatment must be carefully individualized. Future studies should focus on the choice of surgical technique, perioperative blood management, and intraoperative navigation as potential protective factors.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00586-023-07919-7","type":"journal-article","created":{"date-parts":[[2023,9,15]],"date-time":"2023-09-15T19:07:53Z","timestamp":1694804873000},"page":"185-197","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Risk factors for in-hospital mortality in geriatric patients aged 80 and older with axis fractures: a\u00a0nationwide,\u00a0cross-sectional analysis of concomitant injuries, comorbidities, and treatment strategies in 10,077 cases"],"prefix":"10.1007","volume":"33","author":[{"given":"Maximilian","family":"Kerschbaum","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa","family":"Klute","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leopold","family":"Henssler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Markus","family":"Rupp","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Volker","family":"Alt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0459-9092","authenticated-orcid":false,"given":"Siegmund","family":"Lang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2023,9,15]]},"reference":[{"key":"7919_CR1","doi-asserted-by":"publisher","first-page":"e580","DOI":"10.1016\/S2666-7568(21)00172-0","volume":"2","author":"A-M Wu","year":"2021","unstructured":"Wu A-M, Bisignano C, James SL, Abady GG, Abedi A, Abu-Gharbieh E et al (2021) Global, regional, and national burden of bone fractures in 204 countries and territories, 1990\u20132019: a systematic analysis from the Global Burden of Disease Study 2019. 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