Mortality rates in geriatric patients with spinal cord injuries

2007 ◽  
Vol 7 (3) ◽  
pp. 277-281 ◽  
Author(s):  
Daniel R. Fassett ◽  
James S. Harrop ◽  
Mitchell Maltenfort ◽  
Shiveindra B. Jeyamohan ◽  
John D. Ratliff ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Mortality Rate ◽  
Geriatric Patients ◽  
Spinal Cord Injuries ◽  
Mortality Rates ◽  
Neurological Injury ◽  
Patient Age ◽  
Younger Patients ◽  
Patient Âgé ◽  
Chi Square Analysis

Object The authors undertook this study to evaluate the incidence of spinal cord injury (SCI) in geriatric patients (≥ 70 years of age) and examine the impact of patient age, extent of neurological injury, and spinal level of injury on the mortality rate associated with traumatic SCI. Methods A prospectively maintained SCI database (3481 patients) at a single institution was retrospectively studied for the period from 1978 through 2005. Parameters analyzed included patient age, admission American Spinal Injury Association (ASIA) motor score, level of SCI, mechanism of injury, and mortality data. The data pertaining to the 412 patients 70 years of age and older were compared with those pertaining to the younger cohort using a chi-square analysis. Results Since 1980, the number of SCI-related hospital admissions per year have increased fivefold in geriatric patients and the percentage of geriatric patients within the SCI population has increased from 4.2 to 15.4%. In comparison with younger patients, geriatric patients were found to be less likely to have severe neurological deficits (greater percentage of ASIA Grades C and D injuries), but the mortality rates were higher in the older age group both for the period of hospitalization (27.7% compared with 3.2%, p < 0.001) and during 1-year follow-up. The mortality rates in this older population directly correlate with the severity of neurological injury (1-year mortality rate, ASIA Grade A 66%, Grade D 23%, p < 0.001). The mortality rate in elderly patients with SCI has not changed significantly over the last two decades, and the 1-year mortality rate was greater than 40% in all periods analyzed. Conclusions Spinal cord injuries in older patients are becoming more prevalent. The mortality rate in this patient group is much greater than in younger patients and should be taken into account when aggressive interventions are considered and in counseling families regarding prognosis.

Epidemiology of Spinal Cord Injuries and Their Outcomes: A Study at King Khalid Hospital (KKH), Najran, Saudi Arabia, June 2018–June 2019

2021 ◽  
pp. 30
Author(s):  
Ahood Mahjari
Keyword(s):  
Spinal Cord ◽  
Saudi Arabia ◽  
Traffic Accident ◽  
Spinal Cord Injuries ◽  
Road Traffic ◽  
Neurological Injury ◽  
National Data ◽  
Common Cause ◽  
Younger Age ◽  
Cord Injury

Introduction: Spinal cord injury (SCI) is a life-changing neurological injury that puts a significant load on the healthcare system. SCI can be caused by several reasons such as road traffic accident (RTA), motor traffic accident (MTA), fall, gunshots, or bomb blast. There is not much national data concerning the etiology of SCI in Saudi Arabia. Therefore, we conducted this study to quantify the number of SCI incidence at King Khalid Hospital (KKH), Najran between June 2018 and June 2019. The study aimed at reviewing the rate and epidemiology of SCI at KKH for all patients admitted to the hospital during the study period and examining the causes of SCI for suggesting prevention strategies. Methodology: This retrospective study included all patients with SCI admitted to KKH during the mentioned period. Several factors for each patient were recorded including their age, gender, nationality, cause of SCI, and the outcomes of neurological injury. Result: In total, 182 SCI patients were admitted during the study period: 53% of them were male, and those aged 16–30 years were most vulnerable to SCI. RTA was the most common cause of SCI for males (59%), followed by bomb blasts (15%). While fall was ranked as the second cause of SCI in males (15.4%), it was the main reason for SCI in females 13%, followed by RTA. The majority of admitted cases in younger age was stable and improved, however, after RTA four patients had quadriplegia and six cases had paraplegia. Conclusion: RTA is the most common cause of SCI followed by fall and bomb blast. Younger patients are more likely to improve after SCI compared to elderly patients.

Therapeutic trial of hypercarbia and hypocarbia in acute experimental spinal cord injury

1984 ◽  
Vol 61 (5) ◽  
pp. 925-930 ◽  
Author(s):  
Ronald W. J. Ford ◽  
David N. Malm
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Spinal Cord Injuries ◽  
Mortality Rates ◽  
Therapeutic Trial ◽  
Tissue Preservation ◽  
Content Type ◽  
Experimental Spinal Cord Injury ◽  
Cord Injury ◽  
Fine Print

✓ Hypocarbia, normocarbia, or hypercarbia was maintained for an 8-hour period beginning 30 minutes after acute threshold spinal cord injuries in cats. No statistically significant differences in neurological recovery or histologically assessed tissue preservation were found among the three groups of animals 6 weeks after injury. No animal recovered the ability to walk. It is concluded that maintenance of hypercarbia or hypocarbia during the early postinjury period is no more therapeutic than maintenance of normocarbia. Mortality rates and tissue preservation data suggest, however, that postinjury hypocarbia may be less damaging than hypercarbia.

scholarly journals Anti-tumor necrosis factor therapy in patients with inflammatory bowel disease; comorbidity, not patient age, is a predictor of severe adverse events

2020 ◽  
Vol 35 (12) ◽  
pp. 2331-2338
Author(s):  
Vera E. R. Asscher ◽  
◽  
Quirine van der Vliet ◽  
Karen van der Aalst ◽  
Anniek van der Aalst ◽  
...  
Keyword(s):  
Tumor Necrosis Factor ◽  
Adverse Events ◽  
Older Patients ◽  
Tumor Necrosis ◽  
Patient Age ◽  
Younger Patients ◽  
Patient Âgé ◽  
Serious Infections ◽  
Severe Adverse Events ◽  
Necrosis Factor

Abstract Purpose To assess safety and effectiveness of anti-tumor necrosis factor (anti-TNF) therapy in IBD patients ≥ 60 years. Methods Ninety IBD patients ≥ 60 years at initiation of anti-TNF therapy, 145 IBD patients ≥ 60 years without anti-TNF therapy and 257 IBD patients < 60 years at initiation of anti-TNF therapy were retrospectively included in this multicentre study. Primary outcome was the occurrence of severe adverse events (SAEs), serious infections and malignancies. Secondary outcome was effectiveness of therapy. Cox regression analyses were used to assess differences in safety and effectiveness. In safety analyses, first older patients with and without anti-TNF therapy and then older and younger patients with anti-TNF therapy were assessed. Results In older IBD patients, the use of anti-TNF therapy was associated with serious infections (aHR 3.920, 95% CI 1.185–12.973, p = .025). In anti-TNF-exposed patients, cardiovascular disease associated with serious infections (aHR 3.279, 95% CI 1.098–9.790, p = .033) and the presence of multiple comorbidities (aHR 9.138 (1.248–66.935), p = .029) with malignancies, while patient age did not associate with safety outcomes. Effectiveness of therapy was not affected by age or comorbidity. Conclusion Older patients receiving anti-TNF therapy have a higher risk of serious infections compared with older IBD patients without anti-TNF therapy, but not compared with younger patients receiving anti-TNF therapy. However, in anti-TNF-exposed patients, comorbidity was found to be an indicator with regards to SAEs. Effectiveness was comparable between older and younger patients.

Pediatric spinal injury: the very young

1988 ◽  
Vol 68 (1) ◽  
pp. 25-30 ◽  
Author(s):  
John R. Ruge ◽  
Grant P. Sinson ◽  
David G. McLone ◽  
Leonard J. Cerullo
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Spinal Cord Injuries ◽  
Spinal Injury ◽  
Causative Factor ◽  
Important Variable ◽  
Neurological Injury ◽  
Content Type ◽  
Significant Difference ◽  
Cord Injury

✓ Maturity of the spine and spine-supporting structures is an important variable distinguishing spinal cord injuries in children from those in adults. Cinical data are presented from 71 children aged 12 years or younger who constituted 2.7% of 2598 spinal cord-injured patients admitted to the authors' institutions from June, 1972, to June, 1986. The 47 children with traumatic spinal cord injury averaged 6.9 years of age and included 20 girls (43%). The etiology of the pediatric injuries differed from that of adult injuries in that falls were the most common causative factor (38%) followed by automobile-related injuries (20%). Ten children (21.3%) had spinal cord injury without radiographic abnormality (SCIWORA), whereas 27 (57%) had evidence of neurological injury. Complete neurological injury was seen in 19% of all traumatic pediatric spinal cord injuries and in 40% of those with SCIWORA. The most frequent level of spinal injury was C-2 (27%, 15 cases) followed by T-10 (13%, seven cases). Upon statistical examination of the data, a subpopulation of children aged 3 years or younger emerged. These very young children had a significant difference in level of injury, requirement for surgical stability, and sex distribution compared to 4- to 12-year-old children.

scholarly journals Focal neurological injury caused by West Nile virus infection may occur independent of patient age and premorbid health

2005 ◽  
Vol 234 (1-2) ◽  
pp. 93-98 ◽  
Author(s):  
Sandeep Bhangoo ◽  
Rowena Chua ◽  
Chris Hammond ◽  
Zebadiah Kimmel ◽  
Irene Semenov ◽  
...  
Keyword(s):  
West Nile Virus ◽  
Virus Infection ◽  
West Nile Virus Infection ◽  
Neurological Injury ◽  
West Nile ◽  
Patient Age ◽  
Patient Âgé

scholarly journals The effect of patient age, the presence of infection and neoplastic disease on the occurrence of dehiscence laparotomy

2011 ◽  
Vol 58 (4) ◽  
pp. 89-92
Author(s):  
Milorad Paunovic
Keyword(s):  
Prospective Study ◽  
General Surgery ◽  
T Test ◽  
Neoplastic Disease ◽  
Patient Age ◽  
Younger Patients ◽  
Neoplastic Diseases ◽  
Abdominal Organs ◽  
Patient Âgé ◽  
The Impact

Background/Aim. Dehiscence after laparotomy is one of the major complications of laparotomy. Laparotomy is a partial or complete wound with disruption and evisceratio abdominal organs and require urgent reintervention. The aim of this study was to determine the impact of age, infection and neoplastic disease on the occurrence of dehiscence laparotomy. Methods. A retrospective-prospective study were included 826 patients operated at the Clinic for General Surgery in Nis in the period from January 2008 to December 2009. The effect of patient age, the presence of infection and neoplastic disease on the occurrence of dehiscence laparotomy. Results are displayed numerically and in percentages. Results. Of the total 32 patients with dehiscence laparotomy, 20 patients were male or 62.5% and 12 female patients, or 37.5%. Patients with dehiscence laparotomy were significantly younger than patients without dehiscence laparotomy (T-test t=3.237, p<0.05). The average age of respondents with dehiscence was 57.93 years, while patients without dehiscence 63.97 years. There is a statistically highly significant correlation between laparotomy dehiscence and infection (X2=62.024, p<0,01). There was a statistically significant association between dehiscence laparotomy and neoplastic diseases (X2 =42,196; p<0,01). Conclusion. With respect to age, dehiscence laparotomy is significantly more common in younger patients. Infection was significantly more frequent in patients with dehiscence laparotomy. In patients with neoplastic diseases dehiscence laparotomy is common.

Pediatric spinal injury: review of 174 hospital admissions

1992 ◽  
Vol 77 (5) ◽  
pp. 700-704 ◽  
Author(s):  
Mark G. Hamilton ◽  
S. Terence Mylks
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Hospital Admissions ◽  
Spinal Injury ◽  
Neurological Injury ◽  
Cervical Cord ◽  
Mature Adult ◽  
Younger Patients ◽  
Cord Injury ◽  
Radiological Abnormality

✓ Injury to the spinal column and spinal cord occurs relatively infrequently in the pediatric population. A review of 174 pediatric patients is presented, representing 5.4% of all patients admitted with spinal injury, Spinal cord injury was present in 45% of patients. A distinct injury profile, explained by anatomical and biomechanical features, distinguishes the young patient with an immature spine from older adolescents with a more mature, adult-like spine. The younger patients, while less likely to have spinal injury, had a higher incidence of neurological injury, in addition to a higher frequency of both spinal cord injury without radiological abnormality and upper cervical cord injury. In addition, younger patients with spinal cord injury and no radiological abnormality were more likely to have complete or severe cord injury. Prognosis was determined by the severity of spinal cord injury. Patients with complete cord injuries showed little improvement, while patients with incomplete injuries generally fared much better, with 74% showing significant improvement and 59% experiencing a complete recovery of neurological functions. There were six deaths, but none was attributed solely to spinal injury. The authors conclude that outcome is quite good after pediatric spinal cord injury that does not produce a physiologically complete cord deficit.

scholarly journals Impact of Comorbidity on Survival Among Men With Localized Prostate Cancer

2011 ◽  
Vol 29 (10) ◽  
pp. 1335-1341 ◽  
Author(s):  
Peter C. Albertsen ◽  
Dirk F. Moore ◽  
Weichung Shih ◽  
Yong Lin ◽  
Hui Li ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Tumor Grade ◽  
Tumor Stage ◽  
Mortality Rates ◽  
Localized Prostate Cancer ◽  
Patient Age ◽  
Patient Âgé ◽  
Specific Mortality ◽  
Cancer Specific Mortality ◽  
Overall Mortality

Purpose To provide patients and clinicians more accurate estimates of comorbidity-specific survival stratified by patient age, tumor stage, and tumor grade. Patients and Methods We conducted a 10-year competing risk analysis of 19,639 men 66 years of age and older identified by the Surveillance, Epidemiology, and End Results (SEER) program linked to Medicare program files. All men were diagnosed with localized prostate cancer and received no surgery or radiation within 180 days of diagnosis. The analysis was stratified by tumor grade and stage and by age and comorbidity at diagnosis classified using the Charlson comorbidity index. Underlying causes of death were obtained from SEER. Results During the first 10 years after diagnosis, men with moderately and poorly differentiated prostate cancer were more likely to die from causes other than their disease. Depending on patient age, Gleason score, and number of comorbidities present at diagnosis, 5-year overall mortality rates for men with stage T1c disease ranged from 11.7% (95% CI, 10.2% to 13.1%) to 65.7% (95% CI, 55.9% to 70.1%), and prostate cancer–specific mortality rates ranged from 1.1% (95% CI, 0.0% to 2.7%) to 16.3% (95% CI, 13.8% to 19.4%). Ten-year overall mortality rates ranged from 28.8% (95% CI, 25.3% to 32.6%) to 94.3% (95% CI, 87.4% to 100%), and prostate cancer–specific mortality rates ranged from 2.0% (95% CI, 0.0% to 5.3%) to 27.5% (95% CI, 21.5% to 36.5%). Conclusion Patients and clinicians should consider using comorbidity-specific data to estimate the threat posed by newly diagnosed localized prostate cancer and the threat posed by competing medical hazards.

ASSESSMENT OF NEUROPSYCHOLOGICAL PARAMETERS AND QUALITY OF LIFE TO EVALUATE OUTCOME IN PATIENTS WITH SURGICALLY TREATED SUPRATENTORIAL MENINGIOMAS

Neurosurgery ◽  
2009 ◽  
Vol 64 (1) ◽  
pp. 40-47 ◽  
Author(s):  
Wolfgang Krupp ◽  
Christoph Klein ◽  
Ronald Koschny ◽  
Heidrun Holland ◽  
Volker Seifert ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Cognitive Performance ◽  
Satisfaction With Life ◽  
Comprehensive Evaluation ◽  
Long Term Results ◽  
Patient Age ◽  
Younger Patients ◽  
Patient Âgé ◽  
Meningioma Surgery

Abstract OBJECTIVE According to current outcomes research programs, assessment of a broad spectrum of parameters, including quality of life indices, is required to adequately reflect the results of a given treatment. We performed a comprehensive evaluation in patients after supratentorial meningioma surgery in a retrospective study. METHODS In 91 consecutive patients, outcome was assessed in individual sessions in patients' homes an average of 15 months (standard deviation, ± 3.6 months) after surgery. The survey included tests of cognitive performance, coping strategies, satisfaction with life, and a structured interview. RESULTS We found a significant negative correlation between patient age and cognitive performance (P &lt; 0.001), with a major decline beginning at the age of 55 years. Despite normal cognitive performance, 73% of younger patients (younger than 55 years) compared with 20% of older patients (P &lt; 0.001) were not satisfied with life. As a major problem, 68% of younger patients described an inability to accept having this severe disease as a young person. Patients living as singles had a higher frequency of depressive coping (P &lt; 0.05) and less satisfaction with life (P &lt; 0.05). CONCLUSION Comprehensive evaluation after meningioma surgery is required to prevent poor long-term results after apparently successful surgery. In our study, tests and structured interviews revealed different aspects, especially concerning patient age. Because demographic variables clearly influenced satisfaction with life, evaluation of quality of life must account for these factors to improve comparison of different studies. However, prospective studies with larger cohorts and control groups are required to prove our hypotheses.

scholarly journals Factors that influence functional ability in individuals with spinal cord injury: A cross-sectional, observational study

2015 ◽  
Vol 71 (1) ◽  
Author(s):  
Bronwyn M. Hastings ◽  
Mokgobadibe V. Ntsiea ◽  
Steve Olorunju
Keyword(s):  
Spinal Cord ◽  
Observational Study ◽  
Functional Ability ◽  
Functional Independence ◽  
Pressure Sores ◽  
Patient Age ◽  
Cross Sectional ◽  
Patient Âgé ◽  
Rehabilitation Facilities ◽  
Influence Functional

Background: Spinal cord injuries result in devastating impairments that can produce severe functional limitations. However, few documented studies have investigated the levels of function and factors that influence functional ability at discharge from in-patient rehabilitation facilities in Gauteng following such injuries. This necessitated further investigation.Method: Fifty participants were recruited for this cross-sectional, observational study. Participants were recruited from one private and one government spinal rehabilitation unit in Gauteng. A custom-developed questionnaire was used to establish the physical and demographic characteristics of the sample, whilst existing classification scales and measures were used to establish the degree of a lesion and a patient’s associated functional ability. Data were analysed using descriptive statistics. Multiple regression analysis was performed to determine factors that influenced the level of functional ability.Results: Patients achieved an average functional independence score of 64.6 (± 27.6) at discharge according to the Spinal Cord Independence Measure III. Longer stays at rehabilitation facilities were associated with higher scores, whereas scores decreased with increasing patient age. Pressure sores and spasticity affected scores negatively. The type of funding also influenced patients’ scores, with government funding being associated with the best outcome. Both the degree and the level at which the injury occurred could be considered predictive measures that influenced functional independence scores.Conclusion: Most participants were not functionally independent at discharge. Factors such as patient age, length of rehabilitation, presence of pressure sores or spasticity, degree of motor ability and location of the injury should be considered in tailoring rehabilitation therapy.

Sign in / Sign up

Export Citation Format

Share Document