The influence of age and gender on rehabilitation outcomes in nontraumatic spinal cord injury

Study Design: Retrospective, 3-year case series. Objective: To investigate the relationship between gender and age and a range variables in patients with nontraumatic spinal cord injury (SCI). Setting: Tertiary medical unit specializing in rehabilitation of patients with nontraumatic SCI. Method: Participants were a consecutive series of 70 adult inpatients with nontraumatic SCI undergoing initial rehabilitation. The variables of interest were demographic characteristics, clinical features, complications, mortality, length of stay (LOS), mobility, bladder and bowel continence, and Functional Independence Measure (FIM) scores. Results: Men were younger than women, but the difference was not statistically significant (median 64 years vs 72.5 years, P= 0.2). There was no statistically significant relationship between age or gender and the following: American Spinal Injury Association grade, level of injury, many SCI complications, mortality, LOS, walking ability, bladder management, and fecal continence. The only SCI complication that was related to age was pressure ulcers (< 65 years = 20% vs > 65 years = 50%, P = 0.04). Patients discharged home were more likely to be younger (P = 0.01) and male (P = 0.03). There was a significant negative correlation between patients' age and the discharge Rasch-transformed FIM motor (Spearman's p = -0.30, P = 0.015) and cognitive (Spearman's p -0.25, P = 0.04) subscores. There were no significant relationships between gender and FIM subscale scores. Conclusions: Gender and age do not significantly influence most aspects of rehabilitation in patients with nontraumatic SCI. Age alone should not be used as a discriminator of ability to benefit from nontraumatic SCI rehabilitation.