Objectives
To investigate the general characteristics and functional outcomes of the spinal cord injury (SCI) in elderly compared with younger patients.
Methods
We reviewed the medical records of the SCI patients who treated and discharged from inpatient rehabilitation clinic service of a tertiary medical institution, retrospectively. A total of 127 patients were enrolled, and divided into two groups according to age; 53 of elderly group (≥60 year) and 73 of younger group (<60 year). Demographics and clinical datas were collected such as age, gender, time since injury, length of hospital stay, cause of injury, severity and level of injury etc. The functional outcomes at admission and discharge were also analyzed; the Korean version of the modified Barthel Index (K-MBI), Spinal Cord Independence Measure II (SCIM II), Walking Index for Spinal Cord Injury (WISCI).
Results
The mean age of the elderly group was 68.3 ± 6.5 years, and younger group was 45.7 ± 11.6 years. In the elderly group, 30 males and 23 females were found, and 61 males and 12 females in the young group, there was a significant difference in the sex ratio. Marital and employment status, and discharge place were also significantly different between two groups. On the other hand, the hospital day was significantly shorter in the elderly group (25.4 ± 11.0) than in the younger group (31.4 ± 13.9) (Table 1).
In the elderly group, with traumatic SCI 60.4% non-traumatic SCI 39.6%, the proportion of non-traumatic SCI was higher than the young group (Traumatic SCI: 76.3%, Non-traumatic SCI: 23.3%) (Table 1). Falls were the most frequent etiology (56.3%), general falls predominated (50.0%) in the elderly group. In contrast, transport accidents (44.6%) was the main cause in younger groups. In non-traumatic causes, spinal stenosis (23.8%) was most frequent in elderly group (Table 2).
The functional outcomes at discharge were improved in both groups compared to admission. In elderly group, K-MBI (29.3 ± 22.0) and SCIM II (33.0 ± 23.1) at admission point were lower than younger group. After rehabilitation, the elderly group showed greater improvement in the K-MBI (elderly group: 14.9 ± 13.4, young group: 10.2 ± 9.9) than the younger group. In addition, the SCIM II was significantly more improved in the elderly group (elderly group: 13.0 ± 15.7, young group: 6.7 ± 11.1) (Table 3).
Conclusions
The present findings showed that the elderly SCI patients differed from young SCI patients in the demographic characteristics, etiology and clinical features. Also, more intensive and adjusted rehabilitation therapy may be needed for the elderly SCI patients. |
