The influence of age at time of spinal cord injury on rehabilitation outcome
M. J. DeVivo, P. L. Kartus, R. D. Rutt, S. L. Stover and P. R. Fine
Department of Rehabilitation Medicine, University of Alabama, Birmingham 35294.
The purpose of this study was to compare the experiences of older and
younger patients with spinal cord injury. Data from 866 patients
hospitalized between 1973 and 1985 were analyzed by age at injury. Outcomes
were measured at discharge and 2 years after injury. Patients who were at
least 61 years of age were 2.1 times more likely to have developed
pneumonia, 2.7 times more likely to have experienced a gastrointestinal
hemorrhage, 5.6 times more likely to have developed pulmonary emboli, and
16.8 times more likely to have had renal stones prior to first definitive
discharge than their 16- to 30-year-old counterparts. Patients who were at
least 61 years of age were 3.9 times more likely to have been
rehospitalized during the second postinjury year than patients in the 16-
to 30-year-old age group; 2.1 times more likely to have required artificial
ventilatory support prior to discharge; 22.7 times more likely to have been
discharged to a nursing home; 71.8 times more likely to be in a nursing
home 2 years after injury; and 7.3 times more likely to have used hired
attendants during the second postinjury year. Two-year survival rates were
59% for patients aged 61 to 86 years and 95% for patients aged 16 to 30
years. Although the prognosis for most patients with spinal cord injury has
improved in recent years, older patients still have a comparatively poor
prognosis.
