Long-term survival in spinal cord injury: a fifty year investigation

Abstract

The aims of this study were to examine long-term survival in a population-based sample of spinal cord injury (SCI) survivors in Great Britain, identify risk factors contributing to deaths and explore trends in cause of death over the decades following SCI. Current survival status was successfully identi®ed in 92.3% of the study sample. Standardised mortality ratios (SMRs) were calculated and compared with a similar USA study. Relative risk ratio analysis showed that higher mortality risk was associated with higher neurologic level and completeness of spinal cord injury, older age at injury and earlier year of injury. For the entire ®fty year time period, the leading cause of death was related to the respiratory system; urinary deaths ranked second followed by heart disease related deaths, but patterns in causes of death changed over time. In the early decades of injury, urinary deaths ranked ®rst, heart disease deaths second and respiratory deaths third. In the last two decades of injury, respiratory deaths ranked ®rst, heart related deaths were second, injury related deaths ranked third and urinary deaths fourth. This study also raises the question of examining alternative neurological groupings for future mortality risk analysis.

The effects of an anabolic agent on body composition and pulmonary function in tetraplegia: a pilot study

“…This decreased pulmonary function results in pulmonary complications that are the most common cause of death and the second leading cause of morbidity in persons with long-term SCI. 8,9 Anabolic steroids have been shown to reduce nitrogen wasting in persons with HIV 10 and severe burns, 11 and be beneficial in individuals with chronic obstructive disease. 12 Preliminary data using oxandrolone suggest that anabolic steroids might also be beneficial in reducing or minimizing some of the complications following SCI.…”

“…Methods: Oxandrolone (20 mg per day) was administered for 8 weeks to 10 men with motor complete tetraplegia. Dual X-ray absorptiometry scans, pulmonary function tests (PFTs), serum lipids and liver function tests (LFTs) were obtained at baseline, 4,8,12 and 20 weeks. To analyze change over time, a repeated measures General Linear Model and nonparametric tests were utilized.…”

International lower urinary tract function basic spinal cord injury data set

“…Causes of death after spinal cord injury (SCI) have changed from being primarily due to urinary tract diseases increasingly to being caused by cardiovascular diseases and respiratory complications, [1][2][3][4] thus becoming more similar to the causes of death in the general population. This is at least true in centres providing centralized care for individuals with SCI.…”

“…6 The longevity in persons with SCI still remains below the life expectancies in the general population. [1][2][3]7,8 Because of the increasing prevalence of individuals living with SCI, both traumatic and nontraumatic lesions, there is an increasing need for data pertaining to SCI. To facilitate comparisons regarding injuries/lesions, treatments and outcomes between patients, centres and countries, such data should be in the form of common international data sets collected on individuals with SCI.…”

Developing core sets for persons with spinal cord injuries based on the International Classification of Functioning, Disability and Health as a way to specify functioning

“…1 Probably because of the increased survival after a traumatic SCI the prevalence of SCI has increased in the last 20 years. 2,3 Prevalence estimates range from 280/million up to 900/million persons with SCI. [3][4][5] The likely result of this increasing prevalence is that there will be a growth in the number of persons with chronic disabling conditions.…”