Traumatic cervical spinal cord injury in southeastern Norway: acute treatment, specialized rehabilitation referral and mortality

Frontiers in Neurology, 2024 · DOI: 10.3389/fneur.2024.1452194 · Published: December 16, 2024

Spinal Cord Injury Trauma Rehabilitation

Simple Explanation

This study examines the treatment and outcomes of patients with traumatic cervical spinal cord injuries (cSCI) in southeastern Norway between 2015 and 2022. The research focuses on factors like the length of hospital stay, surgery rates, referral to specialized rehabilitation, and mortality rates, particularly among elderly patients. The study highlights that advanced age, especially among those over 80, is linked to reduced access to specialized rehabilitation, suggesting a potential need for reassessment of rehabilitation strategies for older patients.

Study Duration

2015-2022

Participants

370 patients with traumatic cervical spinal cord injury

Evidence Level

Population-based cohort study

Key Findings

1
Advanced age, particularly among octogenarians, was significantly associated with a lack of referral to specialized rehabilitation centers.
2
Increased length of hospital stay was associated with younger age, specific AIS grades, surgery, and prolonged ventilator support.
3
Mortality rate was associated with advanced age, preinjury dependent living, severity of cSCI, upper cervical injuries, and days on ventilator.

Research Summary

This population-based cohort study examined patients with traumatic cervical spinal cord injury (cSCI) in Southeastern Norway from 2015 to 2022, focusing on treatment approaches and outcomes. The study found that advanced age, especially among octogenarians, was significantly linked to a lack of specialized rehabilitation, raising concerns about equitable access to care. The research suggests a need for qualified physicians to assess all cSCI patients for rehabilitation potential and a possible expansion of rehabilitation center capacity or development of prioritization guidelines.

Practical Implications

Rehabilitation Access

Healthcare providers should reassess the criteria for rehabilitation referrals, ensuring elderly patients, particularly octogenarians, are not overlooked due to age alone.

Resource Allocation

Healthcare facilities should evaluate and potentially increase the capacity of specialized rehabilitation centers to meet the needs of all eligible cSCI patients.

Treatment Guidelines

The findings suggest a need for developing clear guidelines for prioritizing patients for rehabilitation when resources are limited, ensuring fair and effective allocation.

Study Limitations

1
The database was not specifically designed for this study, potentially limiting the depth of available data.
2
The categorization of rehabilitation is somewhat unvarnished since some patients received rehabilitation at other institutions.
3
A frailty score would probably better reflect the prognosis.

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