{"doi":"10.1007/s00586-021-06982-2","title":"Association of age with the timing of acute spine surgery–effects on neurological outcome after traumatic spinal cord injury","abstract":"PURPOSE: To investigate the association of age with delay in spine surgery and the effects on neurological outcome after traumatic spinal cord injury (SCI). METHODS: Ambispective cohort study (2011-2017) in n = 213 patients consecutively enrolled in a Level I trauma center with SCI care in a metropolitan region in Germany. Age-related differences in the injury to surgery interval and conditions associated with its delay (> 12 h after SCI) were explored using age categories or continuous variables and natural cubic splines. Effects of delayed surgery or age with outcome were analyzed using multiple logistic regression. RESULTS: The median age of the study population was 58.8 years (42.0-74.6 IQR). Older age (≥ 75y) was associated with a prolonged injury to surgery interval of 22.8 h (7.2-121.3) compared to 6.6 h (4.4-47.9) in younger patients (≤ 44y). Main reasons for delayed surgery in older individuals were secondary referrals and multimorbidity. Shorter time span to surgery (≤ 12 h) was associated with higher rates of ASIA impairment scale (AIS) conversion (OR 4.22, 95%CI 1.85-9.65), as mirrored by adjusted spline curves (< 20 h 20-25%, 20-60 h 10-20%, > 60 h < 10% probability of AIS conversion). In incomplete SCI, the probability of AIS conversion was lower in older patients [e.g., OR 0.09 (0.02-0.44) for'45-59y' vs.' ≤ 44y'], as confirmed by spline curves (< 40y 20-80%, ≥ 40y 5-20% probability). CONCLUSION: Older patient age complexifies surgical SCI care and research. Tackling secondary referral to Level I trauma centers and delayed spine surgery imposes as tangible opportunity to improve the outcome of older SCI patients.","journal":"European Spine Journal","year":2021,"id":182276,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":15,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.7455,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2021-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":562520,"name":"Tom Lübstorf","orcid":null,"position":1,"is_corresponding":false},{"id":734117,"name":"Christian Blex","orcid":"0000-0002-8493-3523","position":2,"is_corresponding":false},{"id":286017,"name":"Jan M. Schwab","orcid":"0000-0001-6784-4919","position":3,"is_corresponding":false},{"id":7397,"name":"Ulrike Grittner","orcid":"0000-0003-2595-0224","position":4,"is_corresponding":false},{"id":734118,"name":"Thomas Auhuber","orcid":"0000-0001-7610-041X","position":5,"is_corresponding":false},{"id":734562,"name":"Axel Ekkernkamp","orcid":null,"position":6,"is_corresponding":false},{"id":734563,"name":"Andreas Niedeggen","orcid":null,"position":7,"is_corresponding":false},{"id":734564,"name":"Erik Prillip","orcid":null,"position":8,"is_corresponding":false},{"id":734565,"name":"Magdalena Hoppe","orcid":null,"position":9,"is_corresponding":false},{"id":734119,"name":"Johanna Ludwig","orcid":"0000-0002-3895-5318","position":10,"is_corresponding":false},{"id":734120,"name":"Martin Kreutzträger","orcid":"0000-0002-7491-2278","position":11,"is_corresponding":false},{"id":561911,"name":"Thomas Liebscher","orcid":"0000-0002-6025-6564","position":12,"is_corresponding":false},{"id":561912,"name":"Marcel A. Kopp","orcid":"0000-0001-6832-9599","position":0,"is_corresponding":true}],"reference_count":29,"raw_metadata":null,"created_at":"2026-07-18T23:48:09.223560Z","pmid":"34533643","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}