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World Journal of Urology
Published in: World Journal of Urology 10/2018

01-10-2018 | Topic Paper

Special considerations in the urological management of the older spinal cord injury patient

Authors: Lewis W. Chan, Tomas L. Griebling, Edwin P. Arnold, Peggy S. Chu, Peter W. New, Adrian Wagg

Published in: World Journal of Urology | Issue 10/2018

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Abstract

Purpose

This paper reports the key findings of Committee 8 of the Joint SIU–ICUD Consultation on Urologic Management of the Spinal Cord Injured Patient and address issues pertaining to the older person with a SCI and the time-related changes relevant to their urological, gastrointestinal and functional management.

Methods

A literature review using the Pubmed and Ovid search engines was performed examining pertinent literature regarding SCI in the older patient.

Results

There is a rising incidence of both traumatic and non-traumatic spinal cord injury (SCI) in older people and improvements in healthcare and nutrition mean patients with SCI are living longer. Outcomes after a SCI in the older person are a sum of the effects of injury and its management compounded by specific effects of ageing and the emergence of unrelated comorbidities. Changes in health, comorbidities, cognition and dexterity with ageing have an impact on function and are important considerations in the management of the older patient with SCI. Treatment decisions are thus increasingly complex due to the need to take into account these changes and accompanying polypharmacy. For the person living with a SCI, changes in circumstances (social and financial) have an impact on quality of life and influence management and support strategies.

Conclusions

Older patients with SCI face additional challenges both in the acute setting and with ageing. Clinicians should take into account comorbid conditions, mental health, physical function, cognition and social support in making management decisions. With the global ageing population, health services planning will need to allow for increase in resources required to care for older patients with SCI.
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Metadata
Title
Special considerations in the urological management of the older spinal cord injury patient
Authors
Lewis W. Chan
Tomas L. Griebling
Edwin P. Arnold
Peggy S. Chu
Peter W. New
Adrian Wagg
Publication date
01-10-2018
Publisher
Springer Berlin Heidelberg
Published in
World Journal of Urology / Issue 10/2018
Print ISSN: 0724-4983
Electronic ISSN: 1433-8726
DOI
https://doi.org/10.1007/s00345-018-2326-3

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