D H Alander1, D A Andreychik, E S Stauffer. 1. Southern Illinois University, School of Medicine, Division of Orthopaedics and Rehabilitation, Springfield.
Abstract
STUDY DESIGN: This study retrospectively reviewed consecutive spinal cord injured patients older than 50 years of age. OBJECTIVE: This study established reasonable expectations for the early clinical outcome of cervical spinal cord injured patients greater than 50 years of age. SUMMARY OF BACKGROUND DATA: Previous studies of cervical spinal cord injuries have concentrated on long-term morbidity and mortality. Little data has been reported on the early clinical outcome during rehabilitation. METHODS: Forty-two consecutive patients older than 50 years of age at the time of cervical cord injury were reviewed. Data was collected from the time of injury to discharge from rehabilitation (< 4 months) and included morbidity, mortality, and disposition of the patient. RESULTS: There were 15 complete and 27 incomplete cervical cord lesions. Forty-five percent were caused by falls, 42% by motor vehicle accidents. Serious associated morbidity was 81% in complete cord injuries and 34% in incomplete lesions. Overall mortality was 23%. Complete cord injury mortality rate was 60% in this age group. All patients over 65 years of age with complete cord injuries died. CONCLUSIONS: Incomplete cervical cord lesions have the best prognosis for return to home and a functional lifestyle. Complete cervical cord injuries in patients older than 50 years of age have a 60% mortality rate. Complete cervical cord injuries in patients over 65 years have a poor prognosis for survival.
STUDY DESIGN: This study retrospectively reviewed consecutive spinal cord injured patients older than 50 years of age. OBJECTIVE: This study established reasonable expectations for the early clinical outcome of cervical spinal cord injured patients greater than 50 years of age. SUMMARY OF BACKGROUND DATA: Previous studies of cervical spinal cord injuries have concentrated on long-term morbidity and mortality. Little data has been reported on the early clinical outcome during rehabilitation. METHODS: Forty-two consecutive patients older than 50 years of age at the time of cervical cord injury were reviewed. Data was collected from the time of injury to discharge from rehabilitation (< 4 months) and included morbidity, mortality, and disposition of the patient. RESULTS: There were 15 complete and 27 incomplete cervical cord lesions. Forty-five percent were caused by falls, 42% by motor vehicle accidents. Serious associated morbidity was 81% in complete cord injuries and 34% in incomplete lesions. Overall mortality was 23%. Complete cord injury mortality rate was 60% in this age group. All patients over 65 years of age with complete cord injuries died. CONCLUSIONS: Incomplete cervical cord lesions have the best prognosis for return to home and a functional lifestyle. Complete cervical cord injuries in patients older than 50 years of age have a 60% mortality rate. Complete cervical cord injuries in patients over 65 years have a poor prognosis for survival.