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Impact de l’âge sur la mortalité des patients traumatisés médullaires hospitalisés en réanimation [Impact of age on mortality in patients with acute traumatic spinal cord injury requiring intensive care]
- Source :
- Annales Françaises d'Anesthésie et de Réanimation, Annales Françaises d'Anesthésie et de Réanimation, 2012, 31 (3), pp.196-202. ⟨10.1016/j.annfar.2011.10.019⟩, Annales Françaises d'Anesthésie et de Réanimation, Elsevier Masson, 2012, 31 (3), pp.196-202. ⟨10.1016/j.annfar.2011.10.019⟩
- Publication Year :
- 2012
- Publisher :
- HAL CCSD, 2012.
-
Abstract
- National audience; Objective To evaluate the impact of age (< or ≥ 65 ans) on hospital mortality in traumatic spinal cord injury requiring intensive care. Design Retrospective, monocenter. Patients and methods A total of 131 patients greater or equal to 15 years (< 65 years, n = 109 and ≥ 65 years, n = 22) was analyzed (cervical, n = 71; thoracolumbar, n = 60), over a 10 years period (1998-2008). The hospital and long-term mortality were studied. The risks factors of death were searched by a uni- and multivariate analysis. Intensive care unit (ICU) discharge and long-term neurological recovery, and long-term functional independence measure (FIM) were assessed. Results Hospital mortality was increased in patients greater or equal to 65 years (41% vs 6%, P < 0.001) and long term mortality was not different between the two groups (31% vs 12%, P = 0.150). The risks factors of death were age (HR = 3.44; IC 95%: 1.53-7.72, P = 0.028), previous coronary disease (HR = 3.64; IC 95%: 1.25-10.65; P = 0.018) and fall injury (HR = 2.40; IC 95%: 1.15-5.00, P = 0.020). Among survivors, incompletes forms (Frankel B, C, D, E) were significantly more frequent in older patients at ICU discharge and long term follow up. At long term, FIM was similar in the two groups except a better sphincter control in patient greater or equal to 65 years. Conclusion Mortality rate of older people (≥ 65 years) were greater than those in younger people, mainly caused by an increased hospital mortality. Among survivors, the neurological recovery was better in patients' greater or equal to 65 years, and was associated with a functional status at least comparable than in the youngest patients.
- Subjects :
- Âge
MESH: Aged, 80 and over
MESH: Risk Factors
MESH: Analysis of Variance
MESH: Hospital Mortality
MESH: Intensive Care
MESH: Spinal Cord Injuries
Réanimation
MESH: Treatment Outcome
MESH: Age Factors
MESH: Survivors
MESH: Aged
MESH: Humans
MESH: Middle Aged
MESH: Patient Discharge
MESH: Adult
MESH: Retrospective Studies
[SDV.MHEP.HEG]Life Sciences [q-bio]/Human health and pathology/Hépatology and Gastroenterology
MESH: Recovery of Function
[SDV.MHEP.HEG] Life Sciences [q-bio]/Human health and pathology/Hépatology and Gastroenterology
MESH: Male
MESH: Prospective Studies
MESH: Independent Living
MESH: Young Adult
MESH: Survival Analysis
Traumatisme médullaire
MESH: Acute Disease
MESH: Coronary Disease
MESH: Female
Subjects
Details
- Language :
- French
- ISSN :
- 07507658
- Database :
- OpenAIRE
- Journal :
- Annales Françaises d'Anesthésie et de Réanimation, Annales Françaises d'Anesthésie et de Réanimation, 2012, 31 (3), pp.196-202. ⟨10.1016/j.annfar.2011.10.019⟩, Annales Françaises d'Anesthésie et de Réanimation, Elsevier Masson, 2012, 31 (3), pp.196-202. ⟨10.1016/j.annfar.2011.10.019⟩
- Accession number :
- edsair.dedup.wf.001..721db22a825f6488471f7f7eb4b4d95b