Impact of age on the injury pattern and survival of people with cervical cord injuries

Abstract

Study design: A retrospective, follow-up study. Objectives: To di erentiate the injury pattern and survival of people with cervical cord injuries with onset at di erent ages. Setting: Rehabilitation wards of a university hospital that is a tertiary referral center in Taipei, Taiwan. Methods: The records of acute and traumatic cervical cord injury patients hospitalized from 1989 to 1997 were reviewed. All subjects received comprehensive rehabilitation programs during hospitalization. Their survival status at the end of follow-up was studied. Results: Forty-seven of 109 (43.1%) people with cervical cord injuries were 50 years or older at onset. Older patients were more frequently injured by minor falls, resulting in more incomplete quadriplegia. They also showed fewer spinal fractures, and more demonstrated associated spondylosis and ossi®cation of the posterior longitudinal ligament. Eleven (10.2%) subjects were deceased, found by a linkage to a death registration database at the end of follow-up. The signi®cant predictor of survival status at follow-up was older age at injury using Cox proportional hazards model. Conclusion: Spinal cord injured patients had di erent injury patterns, demanding di erent preventative strategies. Those injured at older ages were at higher risk of mortality according to our study.

Prevalence of spinal cord injury in Australia

“…25 It is not clear why the increase has occurred and it warrants further investigation. The discussion by Kannus et al, 24 Alaranta et al 34 and Liang et al 35 suggests that osteoporosis, ankylosing spondylitis and spondylosis could be contributing factors to the epidemic of elderly male fall-related SCIs. It is also possible that healthy ageing and the 'handy-man movement' carries unforeseen incremental risks by encouraging the elderly to continue to engage in home maintenance activities involving heights, such as cleaning and painting gutters, repairing rooves and picking fruit.…”

Incidence, prevalence and epidemiology of spinal cord injury: what learns a worldwide literature survey?

“…Multiple studies report a negative association of older age at injury, higher neurological level and completeness of SCI with survival of patients with SCI. [31][32][33][34][35][36] Inclusion of health status, community integration, and economic risk factors may result in higher life expectancy estimates. 37 All these variables might influence survival duration estimates and thus prevalence calculation by this method, probably making it less accurate.…”

Spinal Cord Injuries and Disabilities: A Review

“…La edad ha sido establecida como factor predictor significativo de supervivencia en esta población (10); de igual manera, se ha reportado que algunos de los cambios funcionales a largo plazo se asocian de forma importante con esta variable (18), encontrando además que aquellos pacientes lesionados con mayor edad, tienen un mayor riesgo de mortalidad (10).…”

“…Respecto a los factores etiológicos, los traumatismos constituyen aproximadamente el 60% de los casos de lesión medular en países desarrollados (3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15), y cerca del 80% en países en vía de desarrollo como Colombia (17), los traumas son ocasionados con mayor frecuencia por heridas por armas blancas o de fuego, con un porcentaje entre el 20 y el 60% (11,16,17). Los accidentes de tránsito tienen una incidencia global importante que oscila entre el 12 y 63% (7,8,11,12,16,17).…”

“…La etiología de las lesiones medulares es muy variada e incluye causas de origen congénito, traumá-tico, infeccioso, tumoral o secundario a enfermedades sistémicas (1)(2)(3). La mayoría de la literatura científica establece en primera instancia como causa de LM el trauma, se encuentra el asociado a accidentes de tránsito, heridas por arma de fuego, heridas por arma blanca, caídas de altura, inmersiones en aguas poco profundas, accidentes deportivos y accidentes laborales, entre otras (3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17). En segunda instancia se encuentran las lesiones no traumáticas asociadas a factores congénitos, secundarios a diferentes patologías o por intervenciones médicas o quirúrgicas (3).…”