The elderly para- and tetraplegic: special aspects of the urological care

Madersbacher, G; Oberwalder, Michael

doi:10.1038/sc.1987.60

Cited by 15 publications

(12 citation statements)

References 3 publications

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“…Interestingly, this difference included both the ability to perform clean intermittent catheterisation and to void spontaneously. According to Madersbacher 29 older patients have more difficulty performing intermittent catheterisation because of the decreased ability to cope with a new situation, because of higher impairment of balance and of hand functioning and because of pre-existing factors interfering with this technique such as prostatic hyperplasia. The improved bowel function is probably related to the better neurologic recovery of young patients.…”

Section: Discussionmentioning

confidence: 99%

Effects on age on spinal cord lesion patients' rehabilitation

et al. 2003

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Study design: The present study was undertaken to focus the age-related characteristics of a population of traumatic and nontraumatic spinal cord patients. Objectives: to examine demographic, injury and outcome characteristics of older adults with spinal cord lesions as a result of trauma and nontrauma, and to compare these characteristics with those of younger patients in matched cohorts. Setting: Spinal Cord Unit, Fondazione Santa Lucia IRCCS, a large rehabilitation hospital of the centre-south of Italy. Methods: In total, 284 consecutive newly injured patients with traumatic and nontraumatic spinal cord lesions were retrospectively reviewed and divided according to age into two groups: under 50 years (group 1) and over 50 years (group 2). The following information was collected: onset of lesion to admission; injury variables: aetiology, level, associated injuries, medical complications and surgical intervention; length of stay; American Spinal Injury Association (ASIA) impairment and motor scores; Barthel Index (BI) and Rivermead Mobility Index (RMI) to assess independence in daily living; Walking Index for Spinal Cord Injury to assess ambulation; patients destination at discharge. In a subset of 130 subjects, a block design, matching procedure was used to control for the covariant effects of injury characteristics, time from lesion and aetiology on age effects. Results: In the entire group of 284 patients, older subjects had a higher probability of having incomplete tetraplegia of nontraumatic origin; they also showed a shorter length of stay and a higher rate of complications. In the matched cohorts, younger patients showed better neurologic recovery (intended as ASIA impairment grade improvement and motor scores increase), significantly higher Barthel Index and RMI at discharge, a higher level of independence in spontaneous bladder and bowel management and a higher frequency of independent walking. Conclusion: Older individuals with spinal cord injury and disease do well, but have a less favourable outcome in regard to walking, bladder and bowel independence than younger subjects and have more associated medical problems. Different rehabilitative strategies, therefore, are required for older subjects, which maximises the shorter length of stay and provides the necessary medical care and increased physical assistant resources following discharge.

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Section: Discussionmentioning

confidence: 99%

Effects on age on spinal cord lesion patients' rehabilitation

et al. 2003

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“…Similar findings have been reported in a previous study. 27 The implica tions of these observations are important, as is reflected by the finding that patients with indwelling catheters were significantly more likely to have been discharged to nursing homes than were those on intermittent catheterization.…”

Section: Discussionmentioning

confidence: 99%

The older adult with a spinal cord injury

et al. 1992

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Sixty-two consecutive acute spinal cord injury (SCI) patients who were aged 55 years or older were studied and compared to 296 SCI patients of age less than 55 years. Compared to younger patients, the older group had significantly more females (29%), preexisting medical conditions (87%), associated injuries (55%), incomplete quadriplegic patients (63%), and persons whose injuries resulted from falls (53%). There were no differences between groups in frequency of ventilator use, occurrence of medical complications, or acute length of stay, but older patients tended to have fewer surgical spinal fusions (40%), shorter rehabilitation stays (66.5 days), more indwelling urethral cathteters (31%), and more nursing home discharges (19%). With other factors being controlled, advancing age was predictive only of nursing home discharge, and not of acute or rehabilitation lengths of stay. Among older SCI patients, those with complete injuries were nearly 3 times as likely to have been discharged to nursing homes in our series compared to older patients with incomplete lesions. Although many aspects of the presentation, course, and care of older SCI individuals are similar to those of younger patients, there are several unique features of older adults with a SCI.

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“…3 As people with SCI in the older population usually occurred with more complications, they deserved special attention. 5,6 Prior studies observed some clinical characteristics of older people with SCI, including a higher female sex ratio, more cervical cord injuries, more incomplete lesions, and more frequently injured by minor falls. 1,7 ± 10 The differences in neurological level and extent of injuries were believed to be the result of the di erences in causes noted among older patients.…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2001

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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.

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The elderly para- and tetraplegic: special aspects of the urological care

Cited by 15 publications

References 3 publications

Effects on age on spinal cord lesion patients' rehabilitation

Effects on age on spinal cord lesion patients' rehabilitation

The older adult with a spinal cord injury

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

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