학술논문
Neurological recovery rate and predictive factors of incomplete AIS grade C spinal cord injury in the older aged population
Document Type
Article
Author
Tamai, Koji; Terai, Hidetomi; Nakamura, Hiroaki; Yokogawa, Noriaki; Sasagawa, Takeshi; Nakashima, Hiroaki; Segi, Naoki; Ito, Sadayuki; Funayama, Toru; Eto, Fumihiko; Yamaji, Akihiro; Watanabe, Kota; Yamane, Junichi; Takeda, Kazuki; Furuya, Takeo; Yunde, Atsushi; Nakajima, Hideaki; Yamada, Tomohiro; Hasegawa, Tomohiko; Terashima, Yoshinori; Hirota, Ryosuke; Suzuki, Hidenori; Imajo, Yasuaki; Ikegami, Shota; Uehara, Masashi; Tonomura, Hitoshi; Sakata, Munehiro; Hashimoto, Ko; Onoda, Yoshito; Kawaguchi, Kenichi; Haruta, Yohei; Suzuki, Nobuyuki; Kato, Kenji; Uei, Hiroshi; Sawada, Hirokatsu; Nakanishi, Kazuo; Misaki, Kosuke; Kuroda, Akiyoshi; Inoue, Gen; Kakutani, Kenichiro; Kakiuchi, Yuji; Kiyasu, Katsuhito; Tominaga, Hiroyuki; Tokumoto, Hiroto; Iizuka, Yoichi; Takasawa, Eiji; Akeda, Koji; Takegami, Norihiko; Funao, Haruki; Oshima, Yasushi; Kaito, Takashi; Sakai, Daisuke; Yoshii, Toshitaka; Ohba, Tetsuro; Otsuki, Bungo; Seki, Shoji; Miyazaki, Masashi; Ishihara, Masayuki; Okada, Seiji; Imagama, Shiro; Kato, Satoshi
Source
Spinal Cord; April 2024, Vol. 62 Issue: 4 p149-155, 7p
Subject
Language
ISSN
13624393
Abstract
Study design: Retrospective cohort study. Objectives: To define the prognosis and predictive factors for neurological improvement in older patients with incomplete spinal cord injury (SCI) of American Spinal Injury Association Impairment Scale grade C (AIS-C). Settings: Multi-institutions in Japan. Methods: We included patients aged ≥65 years with traumatic SCI of AIS-C who were treated conservatively or surgically with >3 follow-up months. To identify factors related to neurological improvement, patients were divided into three groups according to their neurological status at the final follow-up, with univariate among-group comparisons of demographics, radiographic, and therapeutic factors. Significant variables were included in the multivariate logistic regression analysis. Results: Overall, 296 older patients with SCI of AIS-C on admission were identified (average age: 75.2 years, average follow-up: 18.7 months). Among them, 190 (64.2%) patients improved to AIS-D and 21 (7.1%) patients improved to AIS-E at final follow-up. There were significant among-group differences in age (p= 0.026), body mass index (p= 0.007), status of pre-traumatic activities of daily living (ADL) (p= 0.037), and serum albumin concentrations (p= 0.011). Logistic regression analysis showed no significant differences in variables in the stratified group of patients who improved to AIS-D. Meanwhile, serum albumin was a significant variable in patients who improved to AIS-E (p= 0.026; OR: 6.20, pre-traumatic ADL was omitted due to data skewness). Conclusions: Most older patients with incomplete AIS-C SCI demonstrated at least 1 grade of neurological improvement. However, <10% of patients achieved complete recovery. Key predictors of complete recovery were high serum albumin levels on admission and independent pre-traumatic ADL. Sponsorship: No funding was received for this study.