Impact of age on the injury pattern and survival of people with cervical cord injuries

Study design: A retrospective, follow-up study. Objectives: To differentiate the injury pattern and survival of people with cervical cord injuries with onset at different ages. Setting: Rehabilitation wards of a university hospital that is a tertiary referral center in Taipei, Taiwan. Methods: The records of acute and traumatic cervical cord injury patients hospitalized from 1989 to 1997 were reviewed. All subjects received comprehensive rehabilitation programs during hospitalization. Their survival status at the end of follow-up was studied. Results: Forty-seven of 109 (43.1%) people with cervical cord injuries were 50 years or older at onset. Older patients were more frequently injured by minor falls, resulting in more incomplete quadriplegia. They also showed fewer spinal fractures, and more demonstrated associated spondylosis and ossification of the posterior longitudinal ligament. Eleven (10.2%) subjects were deceased, found by a linkage to a death registration database at the end of follow-up. The significant predictor of survival status at follow-up was older age at injury using Cox proportional hazards model. Conclusion: Spinal cord injured patients had different injury patterns, demanding different preventative strategies. Those injured at older ages were at higher risk of mortality according to our study. Sponsorship: This study was supported in part by grants from the National Taiwan University Hospital (89S2005), Taipei, Taiwan.