Function improvement of inpatients with traumatic spinal cord injury in 69 grade Ⅲ hospitals

  Objective   To analyze the effect of age on the recovery of neurological function of TSCI inpatients with traumatic spinal cord injury (TSCI) at different severity, and provide evidence for the development of targeted treatment plans.

  Methods   Based on the data of the epidemiological survey of TSCI conducted in 4404 TSCI inpatients in 69 grade Ⅲ hospitals in China, independent sample t-test, χ² test and Wilcoxon rank sum test were used to analyze the differences in the characteristics of TSCI inpatients in different age groups. Logistic regression model was used to analyze the interaction between age and injury grade based on the criteria of American Spinal Injury Association (ASIA) at hospital admission before and after adjusting for confounding factors.

  Results   Among 4404 TSCI inpatients, those aged ≥65 years accounted for 20.3%. There was no significant differences in ASIA injury grade at hospital admission and gender between age group ＞65 years and age group ＜65 years (P>0.05), but there were significant differences in hospital stay, injury severity, injury etiology and interval between injury and surgical operation (P<0.05). In the hospitalized treatment, TSCI inpatients with different ASIA injury grades at hospital admission showed different treatment outcomes in different age groups. For the inpatients with ASIA grade C injury, there was significant difference in the function improvement between age group ＜65 years (49.5%) and age group ＞65 years (37.7%, P<0.05). There was no significant difference in the interaction between age and ASIA injury grade at hospital admission before and after adjustment of confounding factors (P>0.05), but the P value of ASIA B, C and age interaction was ＜0.1.

  Conclusion   In the early stage of TSCI, age as a potential effect moderator governing the relationship between spectrum of injury severity and TSCI therapeutic effect. It is suggested that the age of patients should be comprehensively considered and a targeted treatment plan should be formulated in the treatment process.