Spinal Injuries

Spinal Injuries in the Nursing Home

spinral cord injuryAlthough the incidence of traumatic spinal cord injuries in the U.S. has been relatively stable over the last twenty years, there has been an increase in the rates of spinal cord injuries among people who are 65 years of age and older.

The increase in spinal cord injuries in this population is believed to be due to an increase in falls.

In one study (1), researchers looked at more than 63,000 patients who were sixteen years of age or older and suffered from an acute spinal cord injury between 1993 and 2012. The scientists looked at data obtained by the US Nationwide Inpatient Sample (NIS) databases to find trends in the incidence of spinal cord injuries and uncover the cause of these injuries.

They found that the rate of spinal cord injuries has been relatively stable over the 20-year period. There were 53 incidents per 1 million individuals in 1993 and 54 cases per 1 million individuals in 2012.

They discovered, however, that the incidence of spinal cord injuries among individuals 65 years of age and older changed significantly between 1997 and 2000.

There was an increase in spinal cord injuries among the elder from 28 percent between 1997 and 2000 to 66 percent between 2010 and 2012. The main cause of the increase in spinal cord injuries in the elderly were falls.

These people are more active than they used to be in the 1990s, which placed them at a higher risk for falling.

The biggest health concern among the elderly with spinal cord injuries is an increased mortality rate. Many of these people die in the hospital or nursing home. By trying to understand the causes of spinal cord injuries, scientists hope to be able to not only identify which people are at the greatest risk of spinal cord injuries, but to determine if there are preventative measures that can be taken.

The prevention of falls in the elderly problem is a crucial public health issue, particularly as the percentage of the elderly continue to rise. Some interventions may include preventative rehabilitation efforts aimed at improving gait training and balance, and to educate people about the increased risk for spinal cord injuries during recreational activities.

Seniors living in nursing home facilities are at a greater risk of spinal cord injuries due to being dropped during transfers or because of falls occurring due to slippery floors or debris left in the hallways of the nursing facility.

Trends in Spinal Cord Injuries

When the age-stratified incidence rates for spinal cord injuries were evaluated by researchers, it was shown that there was a decreasing trend in injuries among younger age groups, especially males. Things like improved motor vehicle safety features, increased public education and stricter seat belt laws along with stricter DUI/DWI law enforcement may have contributed to the decline in spinal cord injuries in this younger population (2).

It was only the elderly population, both women and men, that showed increases in spinal cord injuries.  There were 84 injuries per million in 1993 and 131 cases per million in 2012 among the age group comprising those older than 65 years of age.

The Risk of Spinal Injuries In The Elderly

Any type of fall in an elderly person can lead to a catastrophic injury. This means that falls in the elderly is a major issue in public health.

Research showed a minor increase in spinal cord surgical procedures performed after spinal cord injury in the elderly (2). The incidence of intervertebral disc excision increased from 11.2 percent to 15.9 percent in the last two decades, while spinal cord compression surgery went from 10.2 percent to 14.9 percent. The percentage of patients with spinal cord injuries who required vena cava filters increased in the early part of this century.

The mortality rate among inpatients was 6.6 percent between 1993 and 1996, while the mortality rate was 7.5 percent between 2010 and 2012. The inpatient mortality rate among the elderly remained particularly high, at 20 percent following a spinal cord injury (2).

References:

  1. Spinal cord injuries increasing among older adults. http://www.livescience.com/51142-spinal-injuries-increasing-older-adults.html.  Accessed 3/18/2016.
  2. Steep rise in spinal cord injuries among the elderly. http://www.medscape.com/viewarticle/846194. Accessed 3/19/2016.
The following two tabs change content below.

Dr. Christine Traxler

Christine Traxler, MD is a retired family practice physician, graduate of the University of Minnesota School of Medicine in 1986, and freelance writer, having worked with patients in rural Minnesota for two decades. She has written several books on medical topics and currently resides in Minneapolis, MN, where she works as a freelance writer on medical topics.

Latest posts by Dr. Christine Traxler (see all)