Article

Prospective Dutch cohort study. OBJECTIVES: To determine
mortality, causes and determinants of death of individuals with spinal cord
injury (SCI) within five years after first inpatient rehabilitation. SETTING: The
Netherlands. METHODS: Patients were included on admission to first clinical
rehabilitation after traumatic or nontraumatic SCI. INCLUSION CRITERIA: age
between 18 and 65, American Spinal Injury Association impairment scale A-D and
expected long-term wheelchair dependency. Information about survival, cause of
death, relevant comorbidity and psychosocial circumstances was obtained from the
rehabilitation physician or general practitioner. Determinants of death were
retrieved from a prospectively collected database. Deceased persons and survivors
were compared using chi(2)-test and t-test. Cox regression analysis was performed
to describe independent predictors of death. The Kaplan-Meier method was used to
calculate survival curves for independent predictors. Excess mortality was
described by a standardized mortality ratio (SMR). RESULTS: Mean duration of
follow up was 6.2 years. A total of 27 persons (12.2%) died during this period
(SMR 5.3). Main causes of death were cardiovascular disease (37.0%), pulmonary
disease (29.6%) and neoplasm (14.8%). Older age at injury, nontraumatic SCI,
family history of cardiovascular disease, less social support and a history of
other medical conditions on admission were related to death. Older age at injury,
nontraumatic SCI and a history of other medical conditions were independent
predictors of death. CONCLUSION: Twelve per cent of persons with SCI who had
survived the acute hospital phase died during follow up (SMR 5.3). The main
causes of death were cardiovascular and pulmonary disease.
- Pays Bas

Langue : ANGLAIS