Julio C Furlan1,2, B Catharine Craven1,2, Michael G Fehlings3,4. 1. Department of Medicine, Division of Physical Medicine and Rehabilitation, University of Toronto , Toronto , Canada. 2. Lyndhurst Centre, Toronto Rehabilitation Institute, University Health Network , Toronto , Canada. 3. Department of Surgery, Division of Neurosurgery, University of Toronto , Toronto , Canada. 4. Spinal Program, Division of Neurosurgery, Toronto Western Hospital, University Health Network , Toronto , Canada.
Abstract
Context/Objective: Prior studies indicate that patient's gender and age can influence treatment choices during spine disease management. This study examines whether individual's gender and age at injury onset influence the waiting time for each step in the surgical management of patients with acute traumatic cervical spinal cord injury (atcSCI). Design: Retrospective cohort study. Setting: Quaternary spine trauma center. Participants: This study included consecutive individuals with atcSCI admitted from August/2002 to October/2008 who were enrolled in the Surgical Trial in Acute Spinal Cord Injury Study (STASCIS). Interventions: Spinal cord decompression. Outcome Measures: Data on the periods of time for each step in the surgical management were analyzed to explore the potential effects of gender and age at injury onset. Results: There were 64 individuals with atcSCI (17 women, 47 men; age range: 18-78 years; mean age: 50.5 ± 2.1 years). Older age was associated with longer stay in the acute spine center, but this association was cofounded by major pre-existing medical co-morbidities. Age did not significantly affect the waiting time for each step in the surgical management of these individuals with atcSCI. Women underwent surgical assessment earlier than men. Gender did not influence other key steps in the surgical management. Conclusion: The study results suggest that older age at injury onset was associated with longer stay in the acute spine care center, and women had a shorter waiting time for surgical assessment than men. Nevertheless, no other age or gender bias was identified in the waiting times for the steps in the management of atcSCI.
Context/Objective: Prior studies indicate that patient's gender and age can influence treatment choices during spine disease management. This study examines whether individual's gender and age at injury onset influence the waiting time for each step in the surgical management of patients with acute traumatic cervical spinal cord injury (atcSCI). Design: Retrospective cohort study. Setting: Quaternary spine trauma center. Participants: This study included consecutive individuals with atcSCI admitted from August/2002 to October/2008 who were enrolled in the Surgical Trial in Acute Spinal Cord Injury Study (STASCIS). Interventions: Spinal cord decompression. Outcome Measures: Data on the periods of time for each step in the surgical management were analyzed to explore the potential effects of gender and age at injury onset. Results: There were 64 individuals with atcSCI (17 women, 47 men; age range: 18-78 years; mean age: 50.5 ± 2.1 years). Older age was associated with longer stay in the acute spine center, but this association was cofounded by major pre-existing medical co-morbidities. Age did not significantly affect the waiting time for each step in the surgical management of these individuals with atcSCI. Women underwent surgical assessment earlier than men. Gender did not influence other key steps in the surgical management. Conclusion: The study results suggest that older age at injury onset was associated with longer stay in the acute spine care center, and women had a shorter waiting time for surgical assessment than men. Nevertheless, no other age or gender bias was identified in the waiting times for the steps in the management of atcSCI.
Authors: Nitin B Jain; Gregory D Ayers; Emily N Peterson; Mitchel B Harris; Leslie Morse; Kevin C O'Connor; Eric Garshick Journal: JAMA Date: 2015-06-09 Impact factor: 56.272
Authors: Lisa R Shugarman; Katherine Mack; Melony E S Sorbero; Haijun Tian; Arvind K Jain; J Scott Ashwood; Steven M Asch Journal: Med Care Date: 2009-07 Impact factor: 2.983
Authors: Dawn L Hershman; Donna Buono; Russell B McBride; Wei Yann Tsai; Kathy Ann Joseph; Victor R Grann; Judith S Jacobson Journal: J Natl Cancer Inst Date: 2008-01-29 Impact factor: 13.506
Authors: Balakrishnan Kichu R Nair; John R Attia; Steven J Bowe; Stephen R Mears; Karen I Hitchcock Journal: Med J Aust Date: 2003 Dec 1-15 Impact factor: 7.738
Authors: Michael G Fehlings; Alexander Vaccaro; Jefferson R Wilson; Anoushka Singh; David W Cadotte; James S Harrop; Bizhan Aarabi; Christopher Shaffrey; Marcel Dvorak; Charles Fisher; Paul Arnold; Eric M Massicotte; Stephen Lewis; Raja Rampersaud Journal: PLoS One Date: 2012-02-23 Impact factor: 3.240
Authors: E J McCaughey; M Purcell; A N McLean; M H Fraser; A Bewick; R J Borotkanics; D B Allan Journal: Spinal Cord Date: 2015-10-13 Impact factor: 2.772