Intermediate-term outcome of cervical spinal cord-injured patients older than 50 years of age
Intermediate-term outcome of cervical spinal cord-injured patients older than 50 years of age
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DOI：
10.1097/00007632-199706010-00003
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发表时间：
1997-06-01
期刊：
影响因子：
3
通讯作者：
Stauffer, ES
中科院分区：
文献类型：
--
作者：
Alander, DH;Parker, J;Stauffer, ES
研究设计.本研究回顾性分析了50岁以上颈脊髓损伤患者的中期临床结局。建立对老年颈髓损伤患者功能预后的合理预期。已经报道了大量脊髓损伤患者的长期发病率和死亡率。然而，这组50岁以后受伤的老年患者的具体功能能力、处置、发病率和死亡率还没有得到很好的定义。研究了41例年龄大于50岁的颈髓损伤患者，评估了功能能力、独立性、日常生活活动需要帮助、性格、发病率和死亡率。所有患者均在同一脊柱损伤机构接受了2年以上（平均5.5年）的随访检查。完全性颈髓病变13例，不完全性颈髓病变28例。随访时患者平均年龄67.5岁，平均随访时间5.5年。脊髓完全损伤的患者没有一个得到改善，所有患者都需要广泛的护理。26例脊髓不完全损伤的患者中有21例（80%）能够在一些辅助下行走。26例患者中19例有独立或接近独立的日常生活能力。26人中有20人（77%）能够返回家园。所有脊髓完全损伤的患者（13/13）在随访时均已死亡。77%（13人中的10人）的患者在第一年内死亡。那些幸存者在受伤后平均活了3.5年。28例脊髓不完全损伤患者中有14例（50%）在随访时死亡。14例死亡中有6例（43%）归因于脊髓损伤并发症。50岁以上颈髓完全损伤患者的功能预后较差。在第一年存活的14%中，所有人都需要广泛的护理，并且没有看到神经系统的改善。脊髓不完全损伤的患者在截肢和回家方面总体结局良好。
Study Design. This study retrospectively reviewed the intermediate-term clinical outcome of patients who were 50 years of age Or older at the time they experienced their cervical spinal cord injury.Objectives. To establish reasonable expectations for the functional outcome in the older patient with cervical spinal cord injury.Background Data. the long-term morbidity and mortality of large groups of patients with spinal cord injury have been reported. The specific functional ability, disposition, morbidity, and mortality of this group of older patients injured after 50 years of age, however, have been less well defined.Methods. Forty-one consecutive patients older than 50 years of age at the time of cervical cord injury were studied, and functional abilities, independence, need for assistance in activities of daily living, disposition, morbidity, and mortality were assessed. All patients had more than 2 years of follow-up examinations (mean, 5.5 years) by the same spine injury service.Results. There were 13 complete and 28 incomplete cervical cord lesions. The mean age of the patients at follow-up examination was 67.5 years, The average follow-up period was 5.5 years after injury. None of the patients with complete cord injury improved, and all required extensive care. Twenty-one (80%) of 26 of the patients with incomplete cord injury were able to ambulate with some assistance. Nineteen of 26 patients had independent or near-independent abilities with activities of daily living. Twenty (77%) of 26 were able to return home., All patients with complete cord injury(13 of 13) had died by the time of the follow-up visit. Seventy-seven percent (10 of 13) of this patient group had died within the first year. Those surviving lived an average of 3.5 years after their injury. fourteen of 28 patients with incomplete cord injury (50%) had died by the time of the follow-up visit. Six (43%) of the 14 deaths were attributed to complications of their spinal cord injury.Conclusion. The functional outcome of the person older than 50 years with a complete cervical cord injury is poor. Of the 14% who survived the first year, all required extensive attendant care, and no neurologic improvement was seen. The patient with an incomplete cord injury has an overall good outcome regarding ambulation and returning to home.