Características clínicas y pronóstico de la lesión medular traumática en pacientes mayores de 75 años |
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| Affiliation: | 1. Unidad de Lesionados Medulares, Instituto de Investigación Biomédica de A Coruña (INIBIC), Complexo Hospitalario Universitario de A Coruña (CHUAC), A Coruña, España;2. Departamento de Fisioterapia, Medicina y Ciencias Biomédicas, Universidad de A Coruña, A Coruña, España;3. Unidad de Estadística y Epidemiología Clínica, Spanish Clinical Research Network (SCReN), Complexo Hospitalario Universitario de A Coruña (CHUAC), A Coruña, España;1. Servicio de Neurocirugía, Hospital Clínico Universitario de Santiago de Compostela, Santiago de Compostela, La Coruña, España;2. Departamento de Cirugía y Especialidades Médico-Quirúrgicas, Universidad de Santiago de Compostela, Santiago de Compostela, La Coruña, España;1. Departamento de Neurocirugía, Complejo Hospitalario Torrecárdenas, Almería, España;2. Departamento de Anatomía Patológica, Complejo Hospitalario Torrecárdenas, Almería, España;1. Department of Neurosurgery, National Institute of Neurology and Neurosurgery Manuel Velasco Suarez, Insurgentes Sur Av. 3877, Barrio La Fama, Postal Code 14269 Mexico City, Mexico;1. Human Neurosciences Department Neurosurgery Division “Sapienza” University, Italy;2. IRCCS “Neuromed” Pozzilli (IS), Italy |
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| Abstract: | ObjectiveTo analyze the incidence and characteristics of traumatic spinal cord injury (SCI) in geriatric population of Galicia (Spain), hospital management and functional prognosis.MethodsComparative retrospective study. Patients admitted with acute traumatic SCI during the time period between January 2010 and December 2016 were included. Two groups established: The elderly over and under 75 years of age, with the latter acting as a control group.ResultsThree hundred seventy-nine patients were studied (27.2% ≥75 years). The main etiology in the >75 years group were falls: 80.6%. There were 65.7% who presented incomplete spinal cord injuries with mean motor index (MI) of 44.9/100. Upon discharge, 90.8% were dependent. Hospital mortality was 34.9%. Those >75 years suffered from more cervical injuries (74.8 vs. 51.2%; p<0.001), longer delay in diagnosis (31.1 vs. 9.2%; p<0.001) and higher hospital mortality (34.9 vs. 3.2%; p<0.001). Fewer surgical interventions were performed, with a longer delay. Percentages for admission into ICU, mechanical ventilation and performing a tracheostomy proved to be similar. There were no significant differences found in the evolution according to the ASIA scale or the MI.Conclusions1) The frequency of traumatic SCI in the elderly in Galicia is high; 2) Neurological evolution is similar to younger patients but the level of dependence is higher; 3) The level of care provided is similar in both groups, except for the surgical indication, and 4) Hospital mortality is high. |
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| Keywords: | Traumatic spinal cord injury Falls Geriatric patient Prognosis |
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