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Arch Phys Med Rehabil. 2009 Apr;90(4):628-33. doi: 10.1016/j.apmr.2008.10.014.

Psychologic factors and risk of mortality after spinal cord injury.

Author information

  • 1College of Health Professions, Medical University of South Carolina, Charleston, SC, USA.

Abstract

OBJECTIVE:

To identify the association of 2 distinct psychologic constructs, personality and purpose in life (PIL), with risk of early mortality among persons with spinal cord injury (SCI).

DESIGN:

Prospective cohort study with health data collected in late 1997 and early 1998 and mortality status ascertained in December 2005.

SETTING:

A large rehabilitation hospital in the southeastern United States.

PARTICIPANTS:

Adults (N=1386) with traumatic SCI, at least 1 year postinjury.

INTERVENTIONS:

Not applicable.

MAIN OUTCOME MEASURES:

We first evaluated the significance of a single psychologic predictor (a total of 6 scales) while controlling for biographic and injury predictors using Cox proportional hazards modeling and subsequently built a comprehensive model based on an optimal group of psychologic variables.

RESULTS:

There were a total of 224 (16.2%) observed deaths in the full sample. The total number of deaths was reduced to 164 in the final statistical model (of 1128 participants) because of missing data. All 6 psychologic factors were statistically significant in the model that was adjusted for biographic and injury factors, whereas only 3 psychologic factors were retained in the final comprehensive model, including 2 personality scales (Impulsive Sensation Seeking, Neuroticism-Anxiety) and the PIL scale. The final comprehensive model only modestly improved the overall prediction of survival compared with the model with only biographic and injury variables, because the pseudo-R(2) increased from 0.121 to 0.129, and the concordance increased from 0.730 to 0.747.

CONCLUSIONS:

The results affirm the importance of psychologic factors in relation to survival after SCI.

PMID:
19345779
[PubMed - indexed for MEDLINE]
PMCID:
PMC3197232
Free PMC Article
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