Factors Affecting Home Discharge of Older Adults With Cervical Spinal Cord Injury in Japan

Abstract

Abstract Study design: Retrospective cohort study. Objective: To investigate the characteristics of cervical spinal cord injury in patients over 65 years and examine the factors influencing their discharge home. Setting: Spinal Injuries Center, Fukuoka, Japan. Methods: We referred to past medical records and our database to extract data regarding consecutive cervical spinal cord injury cases between 2005 and 2020. Patients over 65 years old who were admitted to the hospital within 14 days of injury were selected. A univariate analysis was performed between the home discharge and out-of-home discharge groups. Multiple logistic regression analysis of admission findings and patient background was also performed to examine independent factors influencing home discharge. Results: Over 15 years, we included 219 patients in the study, of whom 41.1% were eventually discharged home. A two-group comparison between the home discharge and out-of-home discharge groups showed significant differences in age at injury, length of hospital stay, rate of American Spinal Injury Association (ASIA) Impairment Scale (AIS:A), cohabitants, ASIA motor score (AMS), and Spinal Cord Independence Measure (SCIM) at initial visit and discharge. Multivariate logistic regression analysis revealed that age at injury (OR: 0.88, 95% CI: 0.83–0.93, p<.0001), percentage of AIS:A at admission (OR: 0.01, 95% CI: 0.10–0.75, p<.05), and AMS at admission (OR: 1.02, 95% CI: 1.01–1.04, p<.0001) were independent factors. Conclusion: More than half the older adult patients with cervical cord injury were discharged outside the home. Age, percentage of AIS:A, and AMS values at admission were independent factors influencing home discharge.