Increased age, injury level linked with greater in-hospital mortality after spinal cord injuries
CHICAGO — Among elderly patients with a spinal cord injury, researchers found the risk of morality was greater when patients had an increased age, level of injury and American Spinal Injury Association Impairment Scale grade, based on data presented at the North American Spine Society Annual Meeting, here.
By identifying multiple factors related to a patient’s spinal cord injury (SCI) and treatment course, researchers sought to predict which elderly patients would succumb to a SCI. In doing this, researchers hoped to possibly avoid a costly and care-intensive health care pathway for these patients.
“What we have done with this study is essentially validated the risk score in the elderly population above the age of 65 [years]. We hope to develop our own sort of side tool, which ultimately will probably be similar to the risk score, but we do want to incorporate some measures of physiologic reserve, such as frailty and other comorbidities,” Daniel Banaszek, MD, FRCSC, said when he presented the results of a study that involved patients aged older than 65 years who were treated at the Rick Hansen Institute in Vancouver, British Columbia, and enrolled in its SCI registry.
Banaszek and colleagues, who used in-hospital mortality as the main outcome measure, found 16% overall in-hospital mortality (215 deaths) among 1,382 patients in the registry who sustained a SCI from 2007 to 2014.
“We had a high percentage of these people die within a week of their admission,” Banaszek said. “What we found [that] is probably not surprising, is that mortality increases with age.”
For example, in-hospital mortality was about 8% in patients aged 65 to 69 years, which increased to 25% in patients aged 75 years or older, the results showed.
In addition, “mortality decreases with increasing [age, and injury severity] AIS grade,” Banaszek said, noting mortality was also greater among patients with a high cervical SCI vs. low cervical SCI.
Another finding of the study was that death in the hospital was twice as likely for elderly patients with an SCI and an injury severity score greater than 25.
“We think this tool will help guide discussion with patients and their families with regard to expectations,” Banaszek said. – by Susan M. Rapp
Inglis T, et al. Abstract 247. Presented at: North American Spine Society Annual Meeting; Sept. 25-28, 2019; Chicago.
Disclosure: Banaszek reports no relevant financial disclosures.