AANS: Spine Spinal Cord Injury Rates Rise Among Older Americans

March 21, 2007

PHILADELPHIA -- Spinal cord injuries among patients 70 and older have increased fivefold over the past three decades, researchers here reported.

PHILADELPHIA, March 21 -- Spinal cord injuries among patients 70 and older have increased fivefold over the past three decades, researchers here reported.

Older patients now account for more than 15% of the total population with spinal cord injuries admitted to a spinal cord injury center serving the Delaware Valley, found James Harrop, M.D., of Jefferson Medical College, and colleagues.

"Falls continue to be the predominant mechanism for geriatric spinal cord injuries, with 74% of geriatric injuries resulting from a fall," said Dr. Harrop at a Phoenix meeting this month of the Joint Section on Disorders of the Spine and Peripheral Nerves of the American Association of Neurological Surgeons.

Despite the relatively minor trauma, "the mortality of these patients is much greater than younger patients and should be factored in when considering aggressive interventions and counseling families regarding prognosis," Dr. Harrop said.

He and colleagues evaluated the occurrence rate of spinal cord injury in geriatric patients, and examined the effect that age, extent of neurological injury, and spinal level of injury has on mortality associated with traumatic spinal cord injury.

They studied retrospective information from a spinal cord injury database maintained prospectively by Jefferson's Regional Spinal Cord Injury Center of the Delaware Valley, also in Philadelphia.

The database included information on 3,483 patients treated from 1976 to 2006, 412 of whom were 70 or older at the time of admission. They looked at various factors, including age, American Spinal Injury Association (ASIA) score at admission, level of injury, mechanism of injury, and deaths. They used chi-square analysis methods to compare older and younger patients.

They found that geriatric admissions for spinal cord injury increased fivefold during the study period, from 4.2% of all patients in 1980, to 15.4% in 2006.

Compared with younger patients, geriatric patients had a greater percentage of ASIA C and D (incomplete) spinal cord injuries, indicating preservation of motor function below the neurological level.

In contrast, in hospital mortality rates were significantly higher among older patients, at 27.7% compared with 3.2% for the younger set (P