Changes in demographic and neurological characteristics in patients of a tertiary spinal cord injury centre with acquired traumatic or non-traumatic spinal cord injury/disease over a 25-year period. Implications for bladder management.

STUDY DESIGN: Retrospective data analysis. OBJECTIVE: To investigate the changes in demographic and neurological characteristics in patients with acquired traumatic or non-traumatic spinal cord injury/disease (SCI/D) over a 25-year period and their implications for rehabilitation and bladder management. SETTING: Specialized tertiary German center for spinal cord injury. METHODS: We retrospectively evaluated the data of SCI/D patients admitted to initial rehabilitation between January 1995 and December 1999 (1st period, n = 461) and between January 2020 and December 2021 (2nd period, n = 441). RESULTS: In the period from January 2020 to December 2021, SCI/D patients were significantly older at the onset of paralysis and more often female, paralyzed due to a non-traumatic cause or incompletely paralyzed than 25 years ago. The proportion of young adult patients (16-45-year-olds) fell from 61.4 to 23.1%, while the proportion of the over 61-year-olds rose from 14.2 to 49.3%. The proportion of non-traumatic SCI/D rose from 20.8 to 53.1%. The duration of primary rehabilitation decreased significantly from 158 to 85 days. The proportion of SCI/D patients with intermittent catheterisation on discharge from primary rehabilitation decreased from 62.7 to 27.2%, while the proportion of patients with indwelling catheter at the time of discharge from primary rehabilitation increased from 10.8 to 52.4%. CONCLUSION: The proven demographic changes should lead to considerations about targeted objectives and quality criteria for initial rehabilitation after acquired SCI/D. Further research on this topic should include patient-reported outcome measures. Adequate bladder management of these often elderly patients with non-traumatic SCI/D remains a challenge.