PMID- 34533643
OWN - NLM
STAT- MEDLINE
DCOM- 20220406
LR  - 20220406
IS  - 1432-0932 (Electronic)
IS  - 0940-6719 (Linking)
VI  - 31
IP  - 1
DP  - 2022 Jan
TI  - Association of age with the timing of acute spine surgery-effects on neurological 
      outcome after traumatic spinal cord injury.
PG  - 56-69
LID - 10.1007/s00586-021-06982-2 [doi]
AB  - 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.
CI  - (c) 2021. The Author(s).
FAU - Kopp, Marcel A
AU  - Kopp MA
AUID- ORCID: 0000-0001-6832-9599
AD  - Clinical and Experimental Spinal Cord Injury Research (Neuroparaplegiology), 
      Department of Neurology and Experimental Neurology, Charite-Universitatsmedizin 
      Berlin, corporate member of Freie Universitat Berlin, Humboldt-Universitat Zu 
      Berlin, and Berlin Institute of Health, Berlin, Germany. marcel.kopp@charite.de.
AD  - Berlin Institute of Health, QUEST-Center for Transforming Biomedical Research, 
      Berlin, Germany. marcel.kopp@charite.de.
FAU - Lubstorf, Tom
AU  - Lubstorf T
AD  - Clinical and Experimental Spinal Cord Injury Research (Neuroparaplegiology), 
      Department of Neurology and Experimental Neurology, Charite-Universitatsmedizin 
      Berlin, corporate member of Freie Universitat Berlin, Humboldt-Universitat Zu 
      Berlin, and Berlin Institute of Health, Berlin, Germany.
FAU - Blex, Christian
AU  - Blex C
AUID- ORCID: 0000-0002-8493-3523
AD  - Clinical and Experimental Spinal Cord Injury Research (Neuroparaplegiology), 
      Department of Neurology and Experimental Neurology, Charite-Universitatsmedizin 
      Berlin, corporate member of Freie Universitat Berlin, Humboldt-Universitat Zu 
      Berlin, and Berlin Institute of Health, Berlin, Germany.
FAU - Schwab, Jan M
AU  - Schwab JM
AUID- ORCID: 0000-0001-6784-4919
AD  - Clinical and Experimental Spinal Cord Injury Research (Neuroparaplegiology), 
      Department of Neurology and Experimental Neurology, Charite-Universitatsmedizin 
      Berlin, corporate member of Freie Universitat Berlin, Humboldt-Universitat Zu 
      Berlin, and Berlin Institute of Health, Berlin, Germany.
AD  - Belford Center for Spinal Cord Injury, Departments of Neurology, Physical 
      Medicine and Rehabilitation, and Neurosciences, The Neuroscience Institute, The 
      Ohio State University, Wexner Medical Center, Columbus, OH, USA.
FAU - Grittner, Ulrike
AU  - Grittner U
AUID- ORCID: 0000-0003-2595-0224
AD  - Institute of Biometry and Clinical Epidemiology, Charite-Universitatsmedizin 
      Berlin, corporate member of Freie Universitat Berlin, Humboldt-Universitat Zu 
      Berlin, and Berlin Institute of Health, Berlin, Germany.
AD  - Berlin Institute of Health, Berlin, Germany.
FAU - Auhuber, Thomas
AU  - Auhuber T
AD  - Medical Management, BG Hospital Unfallkrankenhaus Berlin, Berlin, Germany.
AD  - University of Applied Sciences of the German Statutory Accident Insurance (HGU), 
      Bad Hersfeld, Germany.
FAU - Ekkernkamp, Axel
AU  - Ekkernkamp A
AD  - Clinic for Trauma Surgery and Orthopaedics, BG Hospital Unfallkrankenhaus Berlin, 
      Berlin, Germany.
FAU - Niedeggen, Andreas
AU  - Niedeggen A
AD  - Brandenburg Center for Spinal Cord Injuries, Kliniken Beelitz, 
      Beelitz-Heilstatten, Germany.
AD  - Treatment Centre for Spinal Cord Injuries, BG Hospital Unfallkrankenhaus Berlin, 
      Berlin, Germany.
FAU - Prillip, Erik
AU  - Prillip E
AD  - Treatment Centre for Spinal Cord Injuries, BG Hospital Unfallkrankenhaus Berlin, 
      Berlin, Germany.
FAU - Hoppe, Magdalena
AU  - Hoppe M
AD  - Clinical and Experimental Spinal Cord Injury Research (Neuroparaplegiology), 
      Department of Neurology and Experimental Neurology, Charite-Universitatsmedizin 
      Berlin, corporate member of Freie Universitat Berlin, Humboldt-Universitat Zu 
      Berlin, and Berlin Institute of Health, Berlin, Germany.
AD  - Treatment Centre for Spinal Cord Injuries, BG Hospital Unfallkrankenhaus Berlin, 
      Berlin, Germany.
FAU - Ludwig, Johanna
AU  - Ludwig J
AD  - Treatment Centre for Spinal Cord Injuries, BG Hospital Unfallkrankenhaus Berlin, 
      Berlin, Germany.
FAU - Kreutztrager, Martin
AU  - Kreutztrager M
AD  - Treatment Centre for Spinal Cord Injuries, BG Hospital Unfallkrankenhaus Berlin, 
      Berlin, Germany.
FAU - Liebscher, Thomas
AU  - Liebscher T
AUID- ORCID: 0000-0002-6025-6564
AD  - Clinical and Experimental Spinal Cord Injury Research (Neuroparaplegiology), 
      Department of Neurology and Experimental Neurology, Charite-Universitatsmedizin 
      Berlin, corporate member of Freie Universitat Berlin, Humboldt-Universitat Zu 
      Berlin, and Berlin Institute of Health, Berlin, Germany.
AD  - Treatment Centre for Spinal Cord Injuries, BG Hospital Unfallkrankenhaus Berlin, 
      Berlin, Germany.
LA  - eng
GR  - R01 NS118200/NS/NINDS NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PT  - Research Support, Non-U.S. Gov't
PT  - Research Support, U.S. Gov't, Non-P.H.S.
DEP - 20210917
PL  - Germany
TA  - Eur Spine J
JT  - European spine journal : official publication of the European Spine Society, the 
      European Spinal Deformity Society, and the European Section of the Cervical Spine 
      Research Society
JID - 9301980
SB  - IM
MH  - Aged
MH  - Cohort Studies
MH  - *Decompression, Surgical
MH  - Germany
MH  - Humans
MH  - Middle Aged
MH  - *Spinal Cord Injuries/epidemiology/surgery
MH  - Trauma Centers
MH  - Treatment Outcome
OTO - NOTNLM
OT  - Age
OT  - Demographic change
OT  - Injury to surgery interval
OT  - Neurological outcome
OT  - Secondary referral
EDAT- 2021/09/18 06:00
MHDA- 2022/04/07 06:00
CRDT- 2021/09/17 12:20
PHST- 2021/02/06 00:00 [received]
PHST- 2021/08/24 00:00 [accepted]
PHST- 2021/08/02 00:00 [revised]
PHST- 2021/09/18 06:00 [pubmed]
PHST- 2022/04/07 06:00 [medline]
PHST- 2021/09/17 12:20 [entrez]
AID - 10.1007/s00586-021-06982-2 [pii]
AID - 10.1007/s00586-021-06982-2 [doi]
PST - ppublish
SO  - Eur Spine J. 2022 Jan;31(1):56-69. doi: 10.1007/s00586-021-06982-2. Epub 2021 Sep 
      17.