Research
Effect of older age on treatment decisions and outcomes among patients with traumatic spinal cord injury
Henry Ahn, Christopher S. Bailey, Carly S. Rivers, Vanessa K. Noonan, Eve C. Tsai, Daryl R. Fourney, Najmedden Attabib, Brian K. Kwon, Sean D. Christie, Michael G. Fehlings, Joel Finkelstein, R. John Hurlbert, Andrea Townson, Stefan Parent, Brian Drew, Jason Chen, Marcel F. Dvorak and Rick Hansen Spinal Cord Injury Registry Network
CMAJ September 08, 2015 187 (12) 873-880; DOI: https://doi.org/10.1503/cmaj.150085
Henry Ahn
St. Michael’s Hospital, University of Toronto Spine Program (Ahn), Toronto, Ont.; Western University (Bailey), London, Ont.; Rick Hansen Institute (Rivers, Noonan, Chen), Vancouver, BC; University of British Columbia (Noonan, Kwon, Townson, Dvorak), Vancouver, BC; The Ottawa Hospital, Ottawa Hospital Research Institute, University of Ottawa (Tsai), Ottawa, Ont.; University of Saskatchewan (Fourney), Saskatoon, Sask.; Horizon Health Network/Dalhousie University (Attabib), St. John, NB; Dalhousie University (Christie), Halifax, NS; Division of Neurosurgery and Spinal Program, University of Toronto (Fehlings), Toronto, Ont.; Sunnybrook Health Sciences Centre, University of Toronto (Finkelstein), Toronto, Ont.; University of Calgary Spine Program (Hurlbert), Calgary, Alta.; Hôpital du Sacré-Coeur de Montréal, Hôpital Ste-Justine, Université de Montréal (Parent), Montréal, Que.; Hamilton General Hospital, McMaster University (Drew), Hamilton, Ont.
MD PhDChristopher S. Bailey
St. Michael’s Hospital, University of Toronto Spine Program (Ahn), Toronto, Ont.; Western University (Bailey), London, Ont.; Rick Hansen Institute (Rivers, Noonan, Chen), Vancouver, BC; University of British Columbia (Noonan, Kwon, Townson, Dvorak), Vancouver, BC; The Ottawa Hospital, Ottawa Hospital Research Institute, University of Ottawa (Tsai), Ottawa, Ont.; University of Saskatchewan (Fourney), Saskatoon, Sask.; Horizon Health Network/Dalhousie University (Attabib), St. John, NB; Dalhousie University (Christie), Halifax, NS; Division of Neurosurgery and Spinal Program, University of Toronto (Fehlings), Toronto, Ont.; Sunnybrook Health Sciences Centre, University of Toronto (Finkelstein), Toronto, Ont.; University of Calgary Spine Program (Hurlbert), Calgary, Alta.; Hôpital du Sacré-Coeur de Montréal, Hôpital Ste-Justine, Université de Montréal (Parent), Montréal, Que.; Hamilton General Hospital, McMaster University (Drew), Hamilton, Ont.
MDCarly S. Rivers
St. Michael’s Hospital, University of Toronto Spine Program (Ahn), Toronto, Ont.; Western University (Bailey), London, Ont.; Rick Hansen Institute (Rivers, Noonan, Chen), Vancouver, BC; University of British Columbia (Noonan, Kwon, Townson, Dvorak), Vancouver, BC; The Ottawa Hospital, Ottawa Hospital Research Institute, University of Ottawa (Tsai), Ottawa, Ont.; University of Saskatchewan (Fourney), Saskatoon, Sask.; Horizon Health Network/Dalhousie University (Attabib), St. John, NB; Dalhousie University (Christie), Halifax, NS; Division of Neurosurgery and Spinal Program, University of Toronto (Fehlings), Toronto, Ont.; Sunnybrook Health Sciences Centre, University of Toronto (Finkelstein), Toronto, Ont.; University of Calgary Spine Program (Hurlbert), Calgary, Alta.; Hôpital du Sacré-Coeur de Montréal, Hôpital Ste-Justine, Université de Montréal (Parent), Montréal, Que.; Hamilton General Hospital, McMaster University (Drew), Hamilton, Ont.
PhDVanessa K. Noonan
St. Michael’s Hospital, University of Toronto Spine Program (Ahn), Toronto, Ont.; Western University (Bailey), London, Ont.; Rick Hansen Institute (Rivers, Noonan, Chen), Vancouver, BC; University of British Columbia (Noonan, Kwon, Townson, Dvorak), Vancouver, BC; The Ottawa Hospital, Ottawa Hospital Research Institute, University of Ottawa (Tsai), Ottawa, Ont.; University of Saskatchewan (Fourney), Saskatoon, Sask.; Horizon Health Network/Dalhousie University (Attabib), St. John, NB; Dalhousie University (Christie), Halifax, NS; Division of Neurosurgery and Spinal Program, University of Toronto (Fehlings), Toronto, Ont.; Sunnybrook Health Sciences Centre, University of Toronto (Finkelstein), Toronto, Ont.; University of Calgary Spine Program (Hurlbert), Calgary, Alta.; Hôpital du Sacré-Coeur de Montréal, Hôpital Ste-Justine, Université de Montréal (Parent), Montréal, Que.; Hamilton General Hospital, McMaster University (Drew), Hamilton, Ont.
PT PhDEve C. Tsai
St. Michael’s Hospital, University of Toronto Spine Program (Ahn), Toronto, Ont.; Western University (Bailey), London, Ont.; Rick Hansen Institute (Rivers, Noonan, Chen), Vancouver, BC; University of British Columbia (Noonan, Kwon, Townson, Dvorak), Vancouver, BC; The Ottawa Hospital, Ottawa Hospital Research Institute, University of Ottawa (Tsai), Ottawa, Ont.; University of Saskatchewan (Fourney), Saskatoon, Sask.; Horizon Health Network/Dalhousie University (Attabib), St. John, NB; Dalhousie University (Christie), Halifax, NS; Division of Neurosurgery and Spinal Program, University of Toronto (Fehlings), Toronto, Ont.; Sunnybrook Health Sciences Centre, University of Toronto (Finkelstein), Toronto, Ont.; University of Calgary Spine Program (Hurlbert), Calgary, Alta.; Hôpital du Sacré-Coeur de Montréal, Hôpital Ste-Justine, Université de Montréal (Parent), Montréal, Que.; Hamilton General Hospital, McMaster University (Drew), Hamilton, Ont.
MD PhDDaryl R. Fourney
St. Michael’s Hospital, University of Toronto Spine Program (Ahn), Toronto, Ont.; Western University (Bailey), London, Ont.; Rick Hansen Institute (Rivers, Noonan, Chen), Vancouver, BC; University of British Columbia (Noonan, Kwon, Townson, Dvorak), Vancouver, BC; The Ottawa Hospital, Ottawa Hospital Research Institute, University of Ottawa (Tsai), Ottawa, Ont.; University of Saskatchewan (Fourney), Saskatoon, Sask.; Horizon Health Network/Dalhousie University (Attabib), St. John, NB; Dalhousie University (Christie), Halifax, NS; Division of Neurosurgery and Spinal Program, University of Toronto (Fehlings), Toronto, Ont.; Sunnybrook Health Sciences Centre, University of Toronto (Finkelstein), Toronto, Ont.; University of Calgary Spine Program (Hurlbert), Calgary, Alta.; Hôpital du Sacré-Coeur de Montréal, Hôpital Ste-Justine, Université de Montréal (Parent), Montréal, Que.; Hamilton General Hospital, McMaster University (Drew), Hamilton, Ont.
MDNajmedden Attabib
St. Michael’s Hospital, University of Toronto Spine Program (Ahn), Toronto, Ont.; Western University (Bailey), London, Ont.; Rick Hansen Institute (Rivers, Noonan, Chen), Vancouver, BC; University of British Columbia (Noonan, Kwon, Townson, Dvorak), Vancouver, BC; The Ottawa Hospital, Ottawa Hospital Research Institute, University of Ottawa (Tsai), Ottawa, Ont.; University of Saskatchewan (Fourney), Saskatoon, Sask.; Horizon Health Network/Dalhousie University (Attabib), St. John, NB; Dalhousie University (Christie), Halifax, NS; Division of Neurosurgery and Spinal Program, University of Toronto (Fehlings), Toronto, Ont.; Sunnybrook Health Sciences Centre, University of Toronto (Finkelstein), Toronto, Ont.; University of Calgary Spine Program (Hurlbert), Calgary, Alta.; Hôpital du Sacré-Coeur de Montréal, Hôpital Ste-Justine, Université de Montréal (Parent), Montréal, Que.; Hamilton General Hospital, McMaster University (Drew), Hamilton, Ont.
MDBrian K. Kwon
St. Michael’s Hospital, University of Toronto Spine Program (Ahn), Toronto, Ont.; Western University (Bailey), London, Ont.; Rick Hansen Institute (Rivers, Noonan, Chen), Vancouver, BC; University of British Columbia (Noonan, Kwon, Townson, Dvorak), Vancouver, BC; The Ottawa Hospital, Ottawa Hospital Research Institute, University of Ottawa (Tsai), Ottawa, Ont.; University of Saskatchewan (Fourney), Saskatoon, Sask.; Horizon Health Network/Dalhousie University (Attabib), St. John, NB; Dalhousie University (Christie), Halifax, NS; Division of Neurosurgery and Spinal Program, University of Toronto (Fehlings), Toronto, Ont.; Sunnybrook Health Sciences Centre, University of Toronto (Finkelstein), Toronto, Ont.; University of Calgary Spine Program (Hurlbert), Calgary, Alta.; Hôpital du Sacré-Coeur de Montréal, Hôpital Ste-Justine, Université de Montréal (Parent), Montréal, Que.; Hamilton General Hospital, McMaster University (Drew), Hamilton, Ont.
MD PhDSean D. Christie
St. Michael’s Hospital, University of Toronto Spine Program (Ahn), Toronto, Ont.; Western University (Bailey), London, Ont.; Rick Hansen Institute (Rivers, Noonan, Chen), Vancouver, BC; University of British Columbia (Noonan, Kwon, Townson, Dvorak), Vancouver, BC; The Ottawa Hospital, Ottawa Hospital Research Institute, University of Ottawa (Tsai), Ottawa, Ont.; University of Saskatchewan (Fourney), Saskatoon, Sask.; Horizon Health Network/Dalhousie University (Attabib), St. John, NB; Dalhousie University (Christie), Halifax, NS; Division of Neurosurgery and Spinal Program, University of Toronto (Fehlings), Toronto, Ont.; Sunnybrook Health Sciences Centre, University of Toronto (Finkelstein), Toronto, Ont.; University of Calgary Spine Program (Hurlbert), Calgary, Alta.; Hôpital du Sacré-Coeur de Montréal, Hôpital Ste-Justine, Université de Montréal (Parent), Montréal, Que.; Hamilton General Hospital, McMaster University (Drew), Hamilton, Ont.
MDMichael G. Fehlings
St. Michael’s Hospital, University of Toronto Spine Program (Ahn), Toronto, Ont.; Western University (Bailey), London, Ont.; Rick Hansen Institute (Rivers, Noonan, Chen), Vancouver, BC; University of British Columbia (Noonan, Kwon, Townson, Dvorak), Vancouver, BC; The Ottawa Hospital, Ottawa Hospital Research Institute, University of Ottawa (Tsai), Ottawa, Ont.; University of Saskatchewan (Fourney), Saskatoon, Sask.; Horizon Health Network/Dalhousie University (Attabib), St. John, NB; Dalhousie University (Christie), Halifax, NS; Division of Neurosurgery and Spinal Program, University of Toronto (Fehlings), Toronto, Ont.; Sunnybrook Health Sciences Centre, University of Toronto (Finkelstein), Toronto, Ont.; University of Calgary Spine Program (Hurlbert), Calgary, Alta.; Hôpital du Sacré-Coeur de Montréal, Hôpital Ste-Justine, Université de Montréal (Parent), Montréal, Que.; Hamilton General Hospital, McMaster University (Drew), Hamilton, Ont.
MD PhDJoel Finkelstein
St. Michael’s Hospital, University of Toronto Spine Program (Ahn), Toronto, Ont.; Western University (Bailey), London, Ont.; Rick Hansen Institute (Rivers, Noonan, Chen), Vancouver, BC; University of British Columbia (Noonan, Kwon, Townson, Dvorak), Vancouver, BC; The Ottawa Hospital, Ottawa Hospital Research Institute, University of Ottawa (Tsai), Ottawa, Ont.; University of Saskatchewan (Fourney), Saskatoon, Sask.; Horizon Health Network/Dalhousie University (Attabib), St. John, NB; Dalhousie University (Christie), Halifax, NS; Division of Neurosurgery and Spinal Program, University of Toronto (Fehlings), Toronto, Ont.; Sunnybrook Health Sciences Centre, University of Toronto (Finkelstein), Toronto, Ont.; University of Calgary Spine Program (Hurlbert), Calgary, Alta.; Hôpital du Sacré-Coeur de Montréal, Hôpital Ste-Justine, Université de Montréal (Parent), Montréal, Que.; Hamilton General Hospital, McMaster University (Drew), Hamilton, Ont.
MDR. John Hurlbert
St. Michael’s Hospital, University of Toronto Spine Program (Ahn), Toronto, Ont.; Western University (Bailey), London, Ont.; Rick Hansen Institute (Rivers, Noonan, Chen), Vancouver, BC; University of British Columbia (Noonan, Kwon, Townson, Dvorak), Vancouver, BC; The Ottawa Hospital, Ottawa Hospital Research Institute, University of Ottawa (Tsai), Ottawa, Ont.; University of Saskatchewan (Fourney), Saskatoon, Sask.; Horizon Health Network/Dalhousie University (Attabib), St. John, NB; Dalhousie University (Christie), Halifax, NS; Division of Neurosurgery and Spinal Program, University of Toronto (Fehlings), Toronto, Ont.; Sunnybrook Health Sciences Centre, University of Toronto (Finkelstein), Toronto, Ont.; University of Calgary Spine Program (Hurlbert), Calgary, Alta.; Hôpital du Sacré-Coeur de Montréal, Hôpital Ste-Justine, Université de Montréal (Parent), Montréal, Que.; Hamilton General Hospital, McMaster University (Drew), Hamilton, Ont.
MDAndrea Townson
St. Michael’s Hospital, University of Toronto Spine Program (Ahn), Toronto, Ont.; Western University (Bailey), London, Ont.; Rick Hansen Institute (Rivers, Noonan, Chen), Vancouver, BC; University of British Columbia (Noonan, Kwon, Townson, Dvorak), Vancouver, BC; The Ottawa Hospital, Ottawa Hospital Research Institute, University of Ottawa (Tsai), Ottawa, Ont.; University of Saskatchewan (Fourney), Saskatoon, Sask.; Horizon Health Network/Dalhousie University (Attabib), St. John, NB; Dalhousie University (Christie), Halifax, NS; Division of Neurosurgery and Spinal Program, University of Toronto (Fehlings), Toronto, Ont.; Sunnybrook Health Sciences Centre, University of Toronto (Finkelstein), Toronto, Ont.; University of Calgary Spine Program (Hurlbert), Calgary, Alta.; Hôpital du Sacré-Coeur de Montréal, Hôpital Ste-Justine, Université de Montréal (Parent), Montréal, Que.; Hamilton General Hospital, McMaster University (Drew), Hamilton, Ont.
MDStefan Parent
St. Michael’s Hospital, University of Toronto Spine Program (Ahn), Toronto, Ont.; Western University (Bailey), London, Ont.; Rick Hansen Institute (Rivers, Noonan, Chen), Vancouver, BC; University of British Columbia (Noonan, Kwon, Townson, Dvorak), Vancouver, BC; The Ottawa Hospital, Ottawa Hospital Research Institute, University of Ottawa (Tsai), Ottawa, Ont.; University of Saskatchewan (Fourney), Saskatoon, Sask.; Horizon Health Network/Dalhousie University (Attabib), St. John, NB; Dalhousie University (Christie), Halifax, NS; Division of Neurosurgery and Spinal Program, University of Toronto (Fehlings), Toronto, Ont.; Sunnybrook Health Sciences Centre, University of Toronto (Finkelstein), Toronto, Ont.; University of Calgary Spine Program (Hurlbert), Calgary, Alta.; Hôpital du Sacré-Coeur de Montréal, Hôpital Ste-Justine, Université de Montréal (Parent), Montréal, Que.; Hamilton General Hospital, McMaster University (Drew), Hamilton, Ont.
MD PhDBrian Drew
St. Michael’s Hospital, University of Toronto Spine Program (Ahn), Toronto, Ont.; Western University (Bailey), London, Ont.; Rick Hansen Institute (Rivers, Noonan, Chen), Vancouver, BC; University of British Columbia (Noonan, Kwon, Townson, Dvorak), Vancouver, BC; The Ottawa Hospital, Ottawa Hospital Research Institute, University of Ottawa (Tsai), Ottawa, Ont.; University of Saskatchewan (Fourney), Saskatoon, Sask.; Horizon Health Network/Dalhousie University (Attabib), St. John, NB; Dalhousie University (Christie), Halifax, NS; Division of Neurosurgery and Spinal Program, University of Toronto (Fehlings), Toronto, Ont.; Sunnybrook Health Sciences Centre, University of Toronto (Finkelstein), Toronto, Ont.; University of Calgary Spine Program (Hurlbert), Calgary, Alta.; Hôpital du Sacré-Coeur de Montréal, Hôpital Ste-Justine, Université de Montréal (Parent), Montréal, Que.; Hamilton General Hospital, McMaster University (Drew), Hamilton, Ont.
MDJason Chen
St. Michael’s Hospital, University of Toronto Spine Program (Ahn), Toronto, Ont.; Western University (Bailey), London, Ont.; Rick Hansen Institute (Rivers, Noonan, Chen), Vancouver, BC; University of British Columbia (Noonan, Kwon, Townson, Dvorak), Vancouver, BC; The Ottawa Hospital, Ottawa Hospital Research Institute, University of Ottawa (Tsai), Ottawa, Ont.; University of Saskatchewan (Fourney), Saskatoon, Sask.; Horizon Health Network/Dalhousie University (Attabib), St. John, NB; Dalhousie University (Christie), Halifax, NS; Division of Neurosurgery and Spinal Program, University of Toronto (Fehlings), Toronto, Ont.; Sunnybrook Health Sciences Centre, University of Toronto (Finkelstein), Toronto, Ont.; University of Calgary Spine Program (Hurlbert), Calgary, Alta.; Hôpital du Sacré-Coeur de Montréal, Hôpital Ste-Justine, Université de Montréal (Parent), Montréal, Que.; Hamilton General Hospital, McMaster University (Drew), Hamilton, Ont.
MScMarcel F. Dvorak
St. Michael’s Hospital, University of Toronto Spine Program (Ahn), Toronto, Ont.; Western University (Bailey), London, Ont.; Rick Hansen Institute (Rivers, Noonan, Chen), Vancouver, BC; University of British Columbia (Noonan, Kwon, Townson, Dvorak), Vancouver, BC; The Ottawa Hospital, Ottawa Hospital Research Institute, University of Ottawa (Tsai), Ottawa, Ont.; University of Saskatchewan (Fourney), Saskatoon, Sask.; Horizon Health Network/Dalhousie University (Attabib), St. John, NB; Dalhousie University (Christie), Halifax, NS; Division of Neurosurgery and Spinal Program, University of Toronto (Fehlings), Toronto, Ont.; Sunnybrook Health Sciences Centre, University of Toronto (Finkelstein), Toronto, Ont.; University of Calgary Spine Program (Hurlbert), Calgary, Alta.; Hôpital du Sacré-Coeur de Montréal, Hôpital Ste-Justine, Université de Montréal (Parent), Montréal, Que.; Hamilton General Hospital, McMaster University (Drew), Hamilton, Ont.
MDSt. Michael’s Hospital, University of Toronto Spine Program (Ahn), Toronto, Ont.; Western University (Bailey), London, Ont.; Rick Hansen Institute (Rivers, Noonan, Chen), Vancouver, BC; University of British Columbia (Noonan, Kwon, Townson, Dvorak), Vancouver, BC; The Ottawa Hospital, Ottawa Hospital Research Institute, University of Ottawa (Tsai), Ottawa, Ont.; University of Saskatchewan (Fourney), Saskatoon, Sask.; Horizon Health Network/Dalhousie University (Attabib), St. John, NB; Dalhousie University (Christie), Halifax, NS; Division of Neurosurgery and Spinal Program, University of Toronto (Fehlings), Toronto, Ont.; Sunnybrook Health Sciences Centre, University of Toronto (Finkelstein), Toronto, Ont.; University of Calgary Spine Program (Hurlbert), Calgary, Alta.; Hôpital du Sacré-Coeur de Montréal, Hôpital Ste-Justine, Université de Montréal (Parent), Montréal, Que.; Hamilton General Hospital, McMaster University (Drew), Hamilton, Ont.
Data supplements
Online Appendices
- Appendix 1: Linear regression model results assessing the effect of age at injury (under 70 years vs ≥ 70 years) on the time from admission to surgery (in hours).
- Appendix 2: Sensitivity analysis for age as factor in the time from acute admission to surgery (in hours) in those receiving surgery following tSCI. The ages of 60, 65, and 75 years were analysed in comparison to the 70 years in the model.
Related Articles
- (2015). Highlights. CMAJ, 187(12), 855. Accessed April 19, 2024. Retrieved from http://www.cmaj.ca/content/187/12/855.
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Effect of older age on treatment decisions and outcomes among patients with traumatic spinal cord injury
Henry Ahn, Christopher S. Bailey, Carly S. Rivers, Vanessa K. Noonan, Eve C. Tsai, Daryl R. Fourney, Najmedden Attabib, Brian K. Kwon, Sean D. Christie, Michael G. Fehlings, Joel Finkelstein, R. John Hurlbert, Andrea Townson, Stefan Parent, Brian Drew, Jason Chen, Marcel F. Dvorak, Rick Hansen Spinal Cord Injury Registry Network
CMAJ Sep 2015, 187 (12) 873-880; DOI: 10.1503/cmaj.150085
Effect of older age on treatment decisions and outcomes among patients with traumatic spinal cord injury
Henry Ahn, Christopher S. Bailey, Carly S. Rivers, Vanessa K. Noonan, Eve C. Tsai, Daryl R. Fourney, Najmedden Attabib, Brian K. Kwon, Sean D. Christie, Michael G. Fehlings, Joel Finkelstein, R. John Hurlbert, Andrea Townson, Stefan Parent, Brian Drew, Jason Chen, Marcel F. Dvorak, Rick Hansen Spinal Cord Injury Registry Network
CMAJ Sep 2015, 187 (12) 873-880; DOI: 10.1503/cmaj.150085