Epidemiological age-based differences in traumatic spinal cord injury patients: A multicenter study based on 13,334 inpatients

Chaoyu Wang; Shenghui Shang; Mengfan Hou; Jinghua Wang; Yi Kang; Yongfu Lou; Wei Wang; Hua Zhao; Lingxiao Chen; Hengxing Zhou; Shiqing Feng

doi:10.1080/10790268.2024.2309716

Epidemiological age-based differences in traumatic spinal cord injury patients: A multicenter study based on 13,334 inpatients

J Spinal Cord Med. 2024 Mar 1:1-9. doi: 10.1080/10790268.2024.2309716. Online ahead of print.

Authors

Chaoyu Wang^{1

2

3}, Shenghui Shang^{1

4}, Mengfan Hou³, Jinghua Wang⁵, Yi Kang³, Yongfu Lou⁴, Wei Wang¹, Hua Zhao¹, Lingxiao Chen⁶, Hengxing Zhou¹, Shiqing Feng^{1

3

4}

Affiliations

¹ Department of Orthopaedics, Qilu Hospital, Shandong University Centre for Orthopaedics, Advanced Medical Research Institute, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, People's Republic of China.
² Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin, People's Republic of China.
³ Department of Orthopaedics, Tianjin Medical University General Hospital, International Science and Technology Cooperation Base of Spinal Cord Injury, Tianjin Key Laboratory of Spine and Spinal Cord, Tianjin, People's Republic of China.
⁴ The Second Hospital of Shandong University, Jinan, Shandong, People's Republic of China.
⁵ Laboratory of Epidemiology, Tianjin Neurological Institute, Department of Neurology, Tianjin Medical University General Hospital & Tianjin Neurological Institute, Key Laboratory of Post-Neuroinjury Neuro-repair and Regeneration in Central Nervous System, Ministry of Education and Tianjin City, Tianjin, People's Republic of China.
⁶ Faculty of Medicine and Health, University of Sydney, Institute of Bone and Joint Research, The Kolling Institute, Sydney, Australia.

PMID: 38426946
DOI: 10.1080/10790268.2024.2309716

Abstract

Context: Compared with younger traumatic spinal cord injury (TSCI) patients, the elderly had longer delays in admission to surgery, higher proportion of incomplete injury, and longer hospital stays. However, in China, the country with the largest number of TSCI patients, there have been no large-scale reports on their age differences.

Objectives: To explore the age-based differences among TSCI inpatients, focusing on the demographic and clinical characteristics, treatment status, and economic burden.

Methods: We collected the medical records of 13,334 inpatients with TSCI in the 30 hospitals of China, from January 1, 2013 to December 31, 2018. Trends are expressed as annual percentage changes (APCs) and 95% confidence intervals (CIs).

Results: A total of 13,334 inpatients were included. Both the number and proportion of the elderly showed an increasing trend. The APC of the number and proportion in patients ≥85 years were 39.5% (95% CI, 14.3 to 70.3; P < 0.01) and 30.5% (95% CI, 8.6 to 56.9; P < 0.01), respectively. Younger patients were more likely to undergo decompression surgery, and older patients were more likely to receive high-dose methylprednisolone sodium succinate/methylprednisolone (MPSS/MP). Of the patients ≥85 years, none underwent decompression surgery within 8 h, and only 1.4% received a high dose of MPSS/MP within 8 h after injury. Elderly patients had lower hospitalization costs than younger. The total and daily medical costs during hospitalization of patients ≥85 years were 8.06 ± 18.80 (IQR: 5.79) and 0.61 ± 0.73 (IQR: 0.55) thousands dollars, respectively.

Conclusions: As the first study to focus on age differences of TSCI patients in China, this study found many differences, in demographic and clinical characteristics, treatment status, and economic costs, between older and younger TSCI patients. The number and proportion of elderly patients increased, and the rate of early surgery for elderly patients is low.

Keywords: Age difference; Demographic and clinical characteristics; Medical costs; Traumatic spinal cord injury; Treatment status.