Article

OBJECTIVE: To evaluate the association of health status, secondary health
conditions, hospitalizations, and risk of mortality and life expectancy (LE)
after spinal cord injury (SCI). DESIGN: Prospective cohort study. SETTING:
Preliminary data were collected from a specialty hospital in the Southeastern
United States, with mortality follow-up and data analysis conducted at a medical
university. PARTICIPANTS: Adults with traumatic SCI (N=1361), all at least 1-year
postinjury at the time of assessment, were enrolled in the study. There were 325
deaths. After elimination of those with missing data on key variables, there were
267 deaths and 12,032 person-years. INTERVENTIONS: None.
MAIN :
The mortality status was determined by routine follow-up using the National Death
Index through December 31, 2008. A logistic regression model was developed to
estimate the probability of dying in any given year using person-years. RESULTS:
A history of chronic pressure ulcers, amputations, a depressive disorder,
symptoms of infections, and being hospitalized within the past year were all
predictive of mortality. LE estimates were generated using the example of a man
with noncervical, nonambulatory SCI. Using 3 age examples (20, 40, 60y), the
greatest estimated lost LE was associated with chronic pressure ulcers (50.3%),
followed by amputations (35.4%), 1 or more recent hospitalizations (18.5%), and
the diagnosis of probable major depression (18%). Symptoms of infections were
associated with a 6.7% reduction in LE for a 1 SD increase in infectious
symptoms. CONCLUSIONS: Several secondary health conditions represent risk factors
for mortality and diminish LE after SCI. The presence of 1 or more of these
factors should be taken as an indicator of the need for intervention.
CI - Copyright (c) 2011 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS