Study investigated the association of age with delay in spine surgery and the effects of the injury to surgery interval and age on neurological outcome after traumatic spinal cord injury (SCI). Data were collected from 213 patients enrolled in a Level I trauma center with SCI care in Germany. Age-related differences in the injury to surgery interval and conditions associated with its delay (more than 12 hours after SCI) were explored using age categories or continuous variables and natural cubic splines. Effects of delayed surgery or age with outcome were analyzed using multiple logistic regression. The median age of the study population was 58.8 years. Older age (≥75 years) was associated with a prolonged injury to surgery interval of 22.8 hours compared to 6.6 hours in younger patients (≤44 years). Main reasons for delayed surgery in older individuals were secondary referrals and multimorbidity. Shorter time span to surgery (≤12 hours) was associated with better neurological outcome across all age groups In incomplete SCI, the adjusted regression models revealed age effects additional to the effects of the injury to surgery interval. Not only delayed spine surgery, but also biological effects of aging on neuronal plasticity and/or regeneration may contribute to a poorer neurological outcome. Findings suggest that managing secondary referral to Level I trauma centers and delayed spine surgery offers a tangible opportunity to improve the outcome of older SCI patients.
Author(s):
Kopp, Marcel A. |Lübstorf, Tom |Blex, Christian |Schwab, Jan M. |Grittner, Ulrike |Auhuber, Thomas |Ekkernkamp, Axel |Niedeggen, Andreas |Prillip, Erik |Hoppe, Magdalena |Ludwig, Johanna |Kreutzträger, Martin |Liebscher, Thomas|
