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Effects of age on survival and neurological recovery of individuals following acute traumatic spinal cord injury

Abstract

Study design

Retrospective cohort study.

Objectives

To evaluate the effects of older age at the time of injury on the individuals’ survival and neurological recovery within the first year after acute traumatic spinal cord injury (tSCI).

Setting

United States.

Methods

This study included all participants enrolled into the First National Acute Spinal Cord Injury Study (NASCIS-1). Outcome measures included survival and neurological recovery (as assessed using the NASCIS motor and sensory scores) within the first year after tSCI. Data analyses of neurological recovery were adjusted for major potential confounders.

Results

The study included 39 females and 267 males with overall mean age of 31 years who mostly sustained cervical severe tSCI after motor vehicle accidents or falls. Survival rates among older individuals are significantly lower than among younger individuals within the first year following tSCI (p < 0.0001). Among who survived the first year of tSCI, there were no statistically significant difference between older survivors and younger survivors regarding motor and sensory recovery in the multiple regression analyses adjusted for major potential confounders.

Conclusions

The results of this retrospective study suggest that older age at the injury onset is associated with lower survival rate within the first year following tSCI. However, older individuals have similar potential to recover from their initial neurological impairment to younger individuals after tSCI. The results of this study combined to the recent literature underline the need for multidisciplinary team approach to the management of the elderly with acute SCI is essential to maximize their recovery.

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Fig. 1: Survival within the first year after acute tSCI.
Fig. 2: Neurological recovery within the first year after acute tSCI.

Data availibity

Data access should be directly requested to the Yale University that led the NASCIS-1 trial.

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Acknowledgements

The author gratefully acknowledges Dr. Michael Bracken who kindly shared the NASCIS-1 database for this research study. This study was carried out without funding support.

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Contributions

As the solo author, Dr. Julio Furlan was responsible for the study design, data analysis and interpretation, manuscript writing and revision. He is accountable for all aspects of this work.

Corresponding author

Correspondence to Julio C. Furlan.

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Competing interests

The author declares no competing interests.

Ethical approval

The Institutional Ethics Board approved the use of database from the NASCIS-1 trial to address research questions other than the original aims of the NASCIS-1 trial. A Data Use Agreement between the Yale University and University Health Network was instituted in 2006.

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Furlan, J.C. Effects of age on survival and neurological recovery of individuals following acute traumatic spinal cord injury. Spinal Cord (2021). https://doi.org/10.1038/s41393-021-00719-0

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