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Spinal Cord. 2019 Apr;57(4):267-275. doi: 10.1038/s41393-018-0212-x. Epub 2018 Nov 9.

Survival after non-traumatic spinal cord injury: evidence from a population-based rehabilitation cohort in Switzerland.

Author information

1
Swiss Paraplegic Research, Nottwil, Switzerland.
2
Department of Health Sciences and Health Policy, University of Lucerne, Lucerne, Switzerland.
3
Institute of Social and Preventative Medicine, University of Bern, Bern, Switzerland.
4
Swiss Paraplegic Center, Nottwil, Switzerland.
5
REHAB Basel, Basel, Switzerland.
6
Clinique Romand de Réadaption, Sion, Switzerland.
7
Spinal Cord Injury Center, Balgrist University Hospital, Zurich, Switzerland.
8
Swiss Paraplegic Research, Nottwil, Switzerland. martin.brinkhof@paraplegie.ch.
9
Department of Health Sciences and Health Policy, University of Lucerne, Lucerne, Switzerland. martin.brinkhof@paraplegie.ch.

Abstract

STUDY DESIGN:

Observational cohort study.

OBJECTIVE:

To investigate survival and life expectancy after NTSCI in Switzerland according to etiology.

SETTING:

Specialized rehabilitation centers in Switzerland.

METHODS:

Longitudinal data from the Swiss Spinal Cord Injury (SwiSCI) medical records study were used. Adjusted hazard ratios (HRs) and life expectancies were estimated using flexible parametric survival modeling.

RESULTS:

One thousand four hundred and fifty individuals were admitted to first rehabilitation for NTSCI between 1990 and 2011, contributing 6137 cumulative person-years at risk and 528 deaths. With reference to persons with a degenerative disc disorder, the HR for mortality in individuals with NTSCIs from infections was 1.42 (95% CI 0.99-2.04), while risk in those with NTSCIs from vascular disorders was 1.28 (95% CI 0.97-1.68). Mortality risk was most pronounced in individuals with NTSCIs from malignant neoplasms (HR 6.32, 95% CI 4.79-8.34). Exemplified for males with an attained age of 60 years, a malignant etiology was associated with 1.7 life years remaining (LYR), as compared to 10.1 LYR for non-malignant etiologies. Males with an attained age of 60 years and a degenerative disc etiology were estimated to have 12.9 LYR.

CONCLUSIONS:

This study contributes an evidence base for risk factors of mortality after NTSCI, reducing a considerable knowledge gap in survival after NTSCI. Survival and life expectancy estimates were highly differential between etiological groups, indicating a need for a heterogeneous clinical approach and dynamic health-care provisions for this growing population.

PMID:
30413804
DOI:
10.1038/s41393-018-0212-x
[Indexed for MEDLINE]

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