dc.contributor.author
Kopp, Marcel A.
dc.contributor.author
Lübstorf, Tom
dc.contributor.author
Blex, Christian
dc.contributor.author
Schwab, Jan M.
dc.contributor.author
Grittner, Ulrike
dc.contributor.author
Auhuber, Thomas
dc.contributor.author
Ekkernkamp, Axel
dc.contributor.author
Niedeggen, Andreas
dc.contributor.author
Prillip, Erik
dc.contributor.author
Hoppe, Magdalena
dc.contributor.author
Ludwig, Johanna
dc.contributor.author
Kreutzträger, Martin
dc.contributor.author
Liebscher, Thomas
dc.date.accessioned
2023-08-10T15:50:05Z
dc.date.available
2023-08-10T15:50:05Z
dc.identifier.uri
https://refubium.fu-berlin.de/handle/fub188/40446
dc.identifier.uri
http://dx.doi.org/10.17169/refubium-40167
dc.description.abstract
Purpose: To investigate the association of age with delay in spine surgery and the effects on neurological outcome after traumatic spinal cord injury (SCI).
Methods: Ambispective cohort study (2011-2017) in n = 213 patients consecutively enrolled in a Level I trauma center with SCI care in a metropolitan region in Germany. Age-related differences in the injury to surgery interval and conditions associated with its delay (> 12 h 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.
Results: The median age of the study population was 58.8 years (42.0-74.6 IQR). Older age (>= 75y) was associated with a prolonged injury to surgery interval of 22.8 h (7.2-121.3) compared to 6.6 h (4.4-47.9) in younger patients (<= 44y). Main reasons for delayed surgery in older individuals were secondary referrals and multimorbidity. Shorter time span to surgery (<= 12 h) was associated with higher rates of ASIA impairment scale (AIS) conversion (OR 4.22, 95%CI 1.85-9.65), as mirrored by adjusted spline curves (< 20 h 20-25%, 20-60 h 10-20%, > 60 h < 10% probability of AIS conversion). In incomplete SCI, the probability of AIS conversion was lower in older patients [e.g., OR 0.09 (0.02-0.44) for'45-59y' vs.' <= 44y'], as confirmed by spline curves (< 40y 20-80%, >= 40y 5-20% probability).
Conclusion: Older patient age complexifies surgical SCI care and research. Tackling secondary referral to Level I trauma centers and delayed spine surgery imposes as tangible opportunity to improve the outcome of older SCI patients.
en
dc.rights.uri
https://creativecommons.org/licenses/by/4.0/
dc.subject
Injury to surgery interval
en
dc.subject
Secondary referral
en
dc.subject
Demographic change
en
dc.subject
Neurological outcome
en
dc.subject.ddc
600 Technik, Medizin, angewandte Wissenschaften::610 Medizin und Gesundheit::610 Medizin und Gesundheit
dc.title
Association of age with the timing of acute spine surgery–effects on neurological outcome after traumatic spinal cord injury
dc.type
Wissenschaftlicher Artikel
dcterms.bibliographicCitation.doi
10.1007/s00586-021-06982-2
dcterms.bibliographicCitation.journaltitle
European Spine Journal
dcterms.bibliographicCitation.number
1
dcterms.bibliographicCitation.originalpublishername
Springer Nature
dcterms.bibliographicCitation.pagestart
56
dcterms.bibliographicCitation.pageend
69
dcterms.bibliographicCitation.volume
31
refubium.affiliation
Charité - Universitätsmedizin Berlin
refubium.funding
Springer Nature DEAL
refubium.resourceType.isindependentpub
no
dcterms.accessRights.openaire
open access
dcterms.bibliographicCitation.pmid
34533643
dcterms.isPartOf.issn
0940-6719
dcterms.isPartOf.eissn
1432-0932