The disease pattern and causes of death of spinal cord injured patients in Japan

Abstract

SummaryIn recent years, the lifespan of patients with spinal cord injury (SCI) in Japan has been markedly prolonged, resulting in changes in the pattern of diseases developing after SCI and causes of death. We carried out a questionnaire survey on these problems and obtained the following results:1. Disease pattern in SCI patients. The morbidity during 3 days in October 1987 and the past history after SCI were investigated in 426 SCI patients, and the results were compared with those in the national health survey carried out by the Japanese government in 1984.The incidence of urological complications and pressure ulcer was high, as was to be expected. In addition, the incidence of diabetes, hypertension, skin diseases, peptic ulcer, and hepatic disease were also significantly higher in the SCI patients.2. Causes of death in SCI patients. Causes of death were analysed in 522 SCI patients who died, and the results were compared with those of the survey undertaken in 1967.The major causes of death were urinary tract infections and respiratory dysfunc tion in the early stage of cervical cord injury. Comparision with the results of the survey in 1967 showed a significant decrease in deaths from urinary tract infection; and a significant increase in those from CV A. Key words: Spinal cord injury; Japan; Aging; Morbidity; Cause of death.With recent advances in the treatment of spinal cord injury (SCI) in the early stage, the lifespan of SCI patients has been markedly prolonged. This has resulted in changes in the pattern of complications developing after SCI, such as an increase in diseases of adults and the resulting changes possibly resulting in death.To evaluate these changes, we carried out a questionnaire survey.

Prevalence of Spinal Cord Injury: An International Comparison

“…Despite the much-cited increase in surviv al rates in recent years [4,8,28] and the result ing increase in prevalence rates, there is little evidence to support a continuing increase. Again, a lack of standard definitions hinders the comparison of different studies over time.…”

Expectations of life and health among spinal cord injured adults

“…14,17 Research suggests that changes in acute treatment and rehabilitation in the early 1970s brought about a signi®cant decrease in premature mortality, especially from respiratory and renal diseases. 1,18,19 Level and completeness of lesion were also found in some studies to be important predictors of mortality. 14,16,17 However, Samsa's 15 more recent cohort showed no eect of level or completeness of lesion on predictions of mortality.…”

Mortality following spinal cord injury

“…The main causes of traumatic spinal cord injury in the State of New South Wales have been identi®ed as motor vehicle accidents (55%), including motor car, motor cycle and pedestrian injuries, falls and crushes (25%), and recreational and sporting accidents (15%), which are similar to other studies. 1,2 Since the Spinal Injuries Unit (SIU) at the Royal North Shore Hospital (RNSH) in Sydney ®rst commenced in 1953, there has been generally reported world-wide improvement in the acute survival of these patients through improved ®rst-aid, rapid transportation to a specialised unit, skilled medical, surgical, and nursing care, and rehabilitation. While some patients still succumb to the eects of multiple trauma, previously common complications such as trophic skin ulceration leading to cellulitis and septicaemia, respiratory tract infection associated with sputum retention and recurrent urinary tract infection are now generally avoided or are adequately managed in specialised units.…”