Recent demographic and injury trends in people served by the model spinal cord injury care systems

Nobunaga, Austin I.; Go, Bette K.; Karunas, R

doi:10.1016/s0003-9993(99)90247-2

Cited by 249 publications

(127 citation statements)

References 7 publications

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“…These findings are all consistent with prior studies. 13,14 After adjusting for trends in age, sex, race, and injury severity, acute care length of stay decreased by 11.4 days and rehabilitation length of stay decreased by 62.6 days over the past 30 years (Table 2) (Po0.01). However, adjusted mean acute care charges in constant 2005 dollars increased by $127 102 (Po0.01), and adjusted mean acute care charges per day increased by $8948 (Po0.01).…”

Section: Resultsmentioning

confidence: 99%

“…The database is also slightly biased in that African Americans, injuries caused by acts of violence, more severe injuries, men, and persons over age 60 years at injury are slightly overrepresented in the NSCISC database. 13,34,35 This bias will affect each outcome differently depending on the relative strength of association of each of these risk factors with each individual outcome. There is no reason to believe that relationships between risk factors and outcomes are different for model system patients than patients treated elsewhere, and no reason to believe that the trend in model system outcomes is biased.…”

Section: Study Limitationsmentioning

confidence: 99%

“…The second reason is that an accurate definition of the current target population is essential for planning and evaluating the effectiveness of primary prevention programs conducted by the model systems and other interested organizations. 1,[13][14][15] …”

Section: Introductionmentioning

confidence: 99%

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Sir Ludwig Guttmann Lecture: Trends in spinal cord injury rehabilitation outcomes from model systems in the United States: 1973–2006

DeVivo

2007

Spinal Cord

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Study design: Consecutive case series with 5-year follow-up. Objective: To evaluate the spinal cord injury (SCI) model systems program in the United States by documenting improvements in treatment outcomes over time. Setting: SCI model systems throughout the United States. Methods: Initial data were collected on 24 332 patients injured between 1973 and 2006. Follow-up data were collected on 9225 of these patients 5 years post-injury. All data were grouped by calendar year. Descriptive statistics included means and percentages. Multiple linear or logistic regression was used to assess outcome trends after adjusting for demographics and injury severity. Results: Acute care and rehabilitation lengths of stay declined dramatically over time (Po0.01). Mean functional independence measure motor score at discharge and gain during rehabilitation decreased, whereas gain per day increased (Po0.01). The probability of neurologic improvement from admission to discharge increased. Odds of medical complications decreased during in-patient treatment, but increased post-discharge (Po0.05). Rehospitalizations declined over time (Po0.01). Community integration improved. First year mortality rates improved, but longer term mortality rates showed no improvement since 1982. Conclusions: Steady improvements have occurred for many treatment outcomes. Newer and more effective methods of prevention and treatment need to be developed to target those outcomes that have not improved and remain suboptimal.

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Section: Resultsmentioning

confidence: 99%

Section: Study Limitationsmentioning

confidence: 99%

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Sir Ludwig Guttmann Lecture: Trends in spinal cord injury rehabilitation outcomes from model systems in the United States: 1973–2006

DeVivo

2007

Spinal Cord

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“…Because of the aging of the population in most developed nations, the incidence of SCI in elderly persons is growing faster than in any other age group (similar to the trends for other fall-related injuries such as hip fractures) (Nobunaga et al, 1999;Kannus et al, 2000;O'Connor, 2006;Kannus et al, 2007). For example in the province of Ontario in Canada, those 65 years of age and older have a higher rate of SCI than the 20-39 year group, leading to a bimodal age profile for SCI (Pickett et al, 2003;Pickett et al, 2006).…”

Section: Introductionmentioning

confidence: 86%

Effects of Advanced Age on the Morphometry and Degenerative State of the Cervical Spine in a Rat Model

Laing

Cox

Tetzlaff

et al. 2011

The Anatomical Record

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Aging causes changes in the geometry of the human cervical spine that may influence the tissue response to applied loads. Rat models are often used to study spinal cord injuries (SCI) and have the potential to enhance our understanding of the effect of age on SCI. The goal of this study was to characterize the morphometry and degenerative state of the cervical spine in Fisher 344 rats, and to determine the influence of age on these variables. Fifteen rats were split into three age groups: young adult (3 months of age), aged (12-18 months) and geriatric (30 months). Following tissue harvest we used a lCT scanner to image the cervical and upper thoracic spine from each specimen. Analysis software was used to measure variables including canal pinch diameter (the most rostral point on the dorsal aspect of a vertebral body to the most caudal aspect of the lamina on the immediately rostral vertebra), vertebral canal depth, width, and area, vertebral body height, depth, width, and area, and intervertebral disc thickness. Orthopaedic surgeons used midsagittal images to rate the degenerative state of the intervertebral discs. For all measures except disc thickness there was a significant increase (mean (SD) ¼ 15.0 (9.7)%) for the aged compared to young specimens (P < 0.05). There were significant differences between the aged and geriatric specimens for only vertebral body depth (P ¼ 0.016) and area (P ¼ 0.020). Intervertebral disc degeneration was significantly greater on the ventral aspect of the spinal column (P < 0.001), with a trend toward increased degeneration in the geriatric specimens (P ¼ 0.069). The results suggest that agerelated morphometric differences may need to be accounted for in experimental aging models of SCI in rats. Anat Rec, 294:1326Rec, 294: -1336Rec, 294: , 2011. V V C 2011 Wiley-Liss, Inc.

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“…23 Of patients admitted to Model Systems SCI care, 11.1% were reported to have sport as the aetiology of injury. 24 Our sample has 10.3% of injuries due to sport.…”

Section: Discussionmentioning

confidence: 99%

Patient perception of the impact of sporting activity on rehabilitation in a spinal cord injuries unit

O'Neill

Maguire

2004

Spinal Cord

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Objective: To establish patients' perception of the effect of sport on rehabilitation. Design: Single investigator telephone questionnaire survey. Setting: Spinal Cord Injuries Unit, Musgrave Park Hospital, Belfast, Northern Ireland, UK. Method: A telephone questionnaire was administered to patients admitted over a 12-month period. Information on patient demographics, sports participation before and after injury and patients' perception of the impact of sports on rehabilitation was recorded. Results: In all, 33 (84.6%) of the 39 patients could be contacted and all completed the questionnaire. Of the respondents 27 (81.8%) had a diagnosis of spinal cord injury. Six (18.2%) were female and 20 (60.6%) were below 45 years. A total of 15 (45.5%) patients previously participated in regular sporting activity. At least 24 (72.7%) tried one sport during admission. In all, 14 reported taking part in regular sporting activity after discharge, although 23 expressed a desire to do so. Of those 60% who had regularly exercised continued to do so and 27% of those who reported no regular sport, before injury, commenced regular active exercise. A general benefit of sporting activity was recognised by 78.8% and a rehabilitation benefit by 69.7%. Self-reported benefits included increase in fitness, quality of life, confidence and social contact. Conclusion: A high proportion of patients perceived sporting activity as beneficial. Patients exercising before injury were more likely to exercise after injury. All inpatients were introduced to sport by staff, emphasising the importance of this rehabilitation opportunity in planning in-patient care.

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Recent demographic and injury trends in people served by the model spinal cord injury care systems

Cited by 249 publications

References 7 publications

Sir Ludwig Guttmann Lecture: Trends in spinal cord injury rehabilitation outcomes from model systems in the United States: 1973–2006

Sir Ludwig Guttmann Lecture: Trends in spinal cord injury rehabilitation outcomes from model systems in the United States: 1973–2006

Effects of Advanced Age on the Morphometry and Degenerative State of the Cervical Spine in a Rat Model

Patient perception of the impact of sporting activity on rehabilitation in a spinal cord injuries unit

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