Abstract:
:Although experience suggests a shift in the epidemiology of spinal cord injury (SCI) toward an older demographic, population studies are lacking. We aimed to evaluate (1) how the epidemiology and age profile of SCI have changed over time, and (2) how increased age impacts health outcomes up to 15 years post-injury. A population-based cohort study was performed in Ontario including adults diagnosed with traumatic SCI between 2002 and 2017. Older and younger SCI cohorts were created based on an age cutoff of 65 years. An older cohort of uninjured persons was matched to the older SCI cohort based on age, gender, and comorbidity status. Changes in crude incidence were reported as average annual percentage change (AAPC). Survival, readmissions, and costs were compared between the older and younger SCI cohorts as well as the between the older SCI and older matched uninjured cohorts. The incidence of SCI increased among females (AAPC 2.2; 95% confidence interval [CI] 0.1, 4.3), driven by a marked rise (4%/year) among elderly females (AAPC 4.3; 95% CI 0.1, 4.3). Although no change in incidence was detected for males, there was a trend toward increased incidence among older males (AAPC 1.2; 95% CI -1.3, 3.8). There were a higher proportion of cervical, incomplete, and fall-related injuries in the older than in younger SCI cohorts. Being over 65 years of age was associated with a sixfold increased risk of death (hazard ratio [HR] 5.75; 95% CI 4.72, 7.00). In comparison with the older uninjured cohort, the older SCI cohort had double the risk of death (HR 2.23; 95% CI 2.00, 2.50). Older persons with SCI had higher odds of readmission and higher costs. The incidence of SCI among the elderly is increasing, particularly among women. Prevention through fall reduction and education to improve outcomes are needed.
journal_name
J Neurotraumajournal_title
Journal of neurotraumaauthors
Wilson JR,Cronin S,Fehlings MG,Kwon BK,Badhiwala JH,Ginsberg HJ,Witiw C,Jaglal Sdoi
10.1089/neu.2020.6985subject
Has Abstractpub_date
2020-08-01 00:00:00pages
1740-1751issue
15eissn
0897-7151issn
1557-9042journal_volume
37pub_type
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journal_title:Journal of neurotrauma
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journal_title:Journal of neurotrauma
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更新日期:2011-11-18 00:00:00
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journal_title:Journal of neurotrauma
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abstract::Guidelines for patients with severe traumatic brain injury (sTBI) published in 2007 recommend providing early nutrition after trauma. Early enteral nutrition (EN) started within 48 h post-injury reduces clinical malnutrition, prevents bacterial translocation from the gastrointestinal tract, and improves outcome in sTB...
journal_title:Journal of neurotrauma
pub_type: 杂志文章,多中心研究
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更新日期:2012-01-01 00:00:00
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journal_title:Journal of neurotrauma
pub_type: 杂志文章
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更新日期:2015-07-15 00:00:00
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journal_title:Journal of neurotrauma
pub_type: 杂志文章
doi:10.1089/neu.1998.15.973
更新日期:1998-11-01 00:00:00
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pub_type: 杂志文章,多中心研究,随机对照试验
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journal_title:Journal of neurotrauma
pub_type: 临床试验,杂志文章
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更新日期:1999-03-01 00:00:00
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pub_type: 杂志文章
doi:10.1089/089771502320914688
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journal_title:Journal of neurotrauma
pub_type: 杂志文章
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更新日期:2009-12-01 00:00:00
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journal_title:Journal of neurotrauma
pub_type: 杂志文章
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journal_title:Journal of neurotrauma
pub_type: 杂志文章
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pub_type: 杂志文章,多中心研究
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更新日期:2012-01-01 00:00:00
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journal_title:Journal of neurotrauma
pub_type: 杂志文章
doi:10.1089/neu.2004.21.1795
更新日期:2004-12-01 00:00:00
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pub_type: 杂志文章
doi:10.1089/neu.2017.5067
更新日期:2018-01-01 00:00:00
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journal_title:Journal of neurotrauma
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更新日期:2000-05-01 00:00:00
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journal_title:Journal of neurotrauma
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doi:10.1089/neu.2006.23.686
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journal_title:Journal of neurotrauma
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journal_title:Journal of neurotrauma
pub_type: 杂志文章
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更新日期:1998-08-01 00:00:00
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pub_type: 杂志文章
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更新日期:2020-04-01 00:00:00
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journal_title:Journal of neurotrauma
pub_type: 杂志文章
doi:10.1089/neu.1993.10.275
更新日期:1993-10-01 00:00:00
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journal_title:Journal of neurotrauma
pub_type: 杂志文章
doi:10.1089/neu.2008.0859
更新日期:2009-12-01 00:00:00
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journal_title:Journal of neurotrauma
pub_type: 杂志文章
doi:10.1089/neu.2006.23.1561
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journal_title:Journal of neurotrauma
pub_type: 杂志文章
doi:10.1089/neu.2011.2278
更新日期:2012-05-01 00:00:00
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pub_type: 杂志文章
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更新日期:2012-07-20 00:00:00
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journal_title:Journal of neurotrauma
pub_type: 杂志文章
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更新日期:2012-01-01 00:00:00