The influence of age at time of spinal cord injury on rehabilitation outcome.

The purpose of this study was to compare the experiences of older and younger patients with spinal cord injury. Data from 866 patients hospitalized between 1973 and 1985 were analyzed by age at injury. Outcomes were measured at discharge and 2 years after injury. Patients who were at least 61 years of age were 2.1 times more likely to have developed pneumonia, 2.7 times more likely to have experienced a gastrointestinal hemorrhage, 5.6 times more likely to have developed pulmonary emboli, and 16.8 times more likely to have had renal stones prior to first definitive discharge than their 16- to 30-year-old counterparts. Patients who were at least 61 years of age were 3.9 times more likely to have been rehospitalized during the second postinjury year than patients in the 16- to 30-year-old age group; 2.1 times more likely to have required artificial ventilatory support prior to discharge; 22.7 times more likely to have been discharged to a nursing home; 71.8 times more likely to be in a nursing home 2 years after injury; and 7.3 times more likely to have used hired attendants during the second postinjury year. Two-year survival rates were 59% for patients aged 61 to 86 years and 95% for patients aged 16 to 30 years. Although the prognosis for most patients with spinal cord injury has improved in recent years, older patients still have a comparatively poor prognosis.