Spinal cord dysfunction in older patients--rehabilitation outcomes

Eighty-seven patients discharged from a rehabilitation ward for spinal cord injured persons at Edward Hines Jr. VA Hospital from October 1, 1982 through September 30, 1984 were retrospectively reviewed for rehabilitation outcomes. Forty-three patients (49%) were 50 years of age or older. Of the older patients, 27 (62%) were quadriplegics. Incomplete lesions were more commonly seen in this group. Twenty-six (60%) did not have x-ray evidence of fracture or dislocation. Falls, spinal stenosis and vascular etiologies were commonly noted. Fifty-four (62%) patients were admitted within 60 days of onset of the spinal cord dysfunction. Five patients died during hospitalization, three of whom were more than 60 years of age. Sixty-seven percent of the older patients were discharged to their homes. Transfers, ambulation, self-care, and bladder and bowel continence levels were reviewed. Associated medical conditions and complications were also analyzed. It appears that the overall rehabilitation outcomes in older patients were quite satisfactory when compared to other spinal cord injury patients, but rehabilitation programs and goals must be modified in order to meet their needs. Long-term planning and management are essential.