Citation

Furlan JC, Fehlings MG. J. Neurotrauma 2009; 26(10): 1707-1717.

Affiliation

Toronto Western Research Institute, University Health Network, Genetics and Development, 399 Bathurst Street, McL 12-407, Toronto, Ontario, Canada, M5T 2S8, 1-416-603-5800 (x3542), 1-416-603-5745; jfurlan@uhnres.utoronto.ca.

Copyright

(Copyright © 2009, Mary Ann Liebert Publishers)

DOI

10.1089/neu.2009-0888

PMID

19413491

PMCID

PMC2822797

Abstract

Given the potential effects of age on mortality, impairment and disability among individuals with traumatic spinal cord injury (SCI), we examined these issues using a large, prospectively accrued clinical database. This study includes all patients who were enrolled in the Third National Spinal Cord Injury Study (NASCIS 3). Motor, sensory and pain outcomes were assessed using NASCIS scores. Functional outcome was evaluated using the Functional Independence Measure (FIM). Data analyses included regression models adjusted for major potential confounders (i.e. sex, ethnicity, Glasgow coma score, blood alcohol concentration on admission, drug protocol, cause, level and severity of SCI). Mortality rates among older people ((3)65 years) were significantly greater than younger individuals at 6 weeks, at 6 months and at 1 year following SCI (38.6% versus 3.1%; p<0.0001). Among survivors, age was not significantly correlated with motor recovery or change in pain scores in the acute and chronic stages after SCI based on regression analyses adjusted for major confounders. However, older individuals experienced greater functional deficit (based on FIM scores) than younger individuals, despite experiencing similar rates of sensorimotor recovery (based on NASCIS scores). Our results suggest that older individuals have a substantially increased mortality rate during the first year following traumatic SCI in comparison with younger patients. Among survivors, the potential of older patients with SCI to neurologically improve within the first year post-injury, this does not appear to translate into similar functional recovery when compared to younger individuals. Given this, rehabilitation protocols that are more focused on functional recovery may reduce disability among older people with acute traumatic SCI.

Language: en