Article

OBJECTIVE: To investigate whether there have been improvements in long-term
survival after spinal cord injury in recent decades.
DESIGN: Survival analysis
using time-varying covariates.
The outcome variable was survival or mortality,
and the explanatory variables were age, sex, level and grade of injury, and
calendar year. The data were analyzed using the logistic regression model,
Poisson regression model with comparison to the general population, and the
computation of standardized mortality ratios for various groups. SETTING:
National Spinal Cord Injury Model Systems facilities. PARTICIPANTS: Persons
(N=31,531) who survived 2 years postinjury, were older than 10 years, and who did
not require ventilator support. These persons contributed 484,979 person-years of
data, with 8536 deaths over the 1973 to 2012 study period. INTERVENTIONS: Not
applicable. MAIN OUTCOME MEASURES: Survival; survival relative to the general
population; life expectancy. RESULTS: After adjustment for age, sex, race,
etiology of injury, time since injury, and level and grade of injury, mortality
in persons with spinal cord injury was higher in the 2005 to 2012 period than in
1990 to 2004 or 1980 to 1989, the odds ratios for these 3 periods were .857,
.826, and .802 as compared with the 1970 to 1979 reference period. CONCLUSIONS:
There was no evidence of improvement. Long-term survival has not changed over the
past 30 years.
CI - Copyright (c) 2015 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS