Differential survival after traumatic spinal cord injury: evidence from a multi-center longitudinal cohort study in Switzerland View Full Text


Ontology type: schema:ScholarlyArticle      Open Access: True


Article Info

DATE

2018-06-12

AUTHORS

Jonviea D. Chamberlain, Hans Peter Gmünder, Kerstin Hug, Xavier Jordan, André Moser, Martin Schubert, Martin W.G. Brinkhof

ABSTRACT

Study designObservational cohort study.ObjectivesTo understand differentials in the force of mortality with increasing time since injury according to key spinal cord injury (SCI) characteristics.SettingSpecialized rehabilitation centers within Switzerland.Methods Data from the Swiss Spinal Cord Injury (SwiSCI) cohort study were used to model mortality in relation to age, sex, and lesion characteristics. Hazard ratios (HRs) and adjusted survival curves were estimated using flexible parametric survival models of time since discharge from first rehabilitation to death or 30 September 2011, whichever came first.Results2 421 persons were included that incurred a new TSCI between 1990 and 2011, contributing a total time-at-risk of 19,604 person-years and 376 deaths. Controlling for attained age, sex, decade, and etiology, there was more than a four-fold higher risk of mortality for complete tetraplegia compared to incomplete paraplegia (HR = 4.27; 95% CI 2.72 to 6.69). Survival estimates differed according to SCI characteristics, with differentials steadily increasing with time since injury.ConclusionThis study provides evidence of disparities in mortality and survival outcomes according to SCI characteristics that increases with increasing time since injury. These results lend support to the hypothesis of a progressive and disproportionate accumulation of allostatic load according to SCI characteristics. Future research should investigate cause-specific mortality for insight into potentially modifiable secondary health conditions contributing to these disparities. More... »

PAGES

920-930

Identifiers

URI

http://scigraph.springernature.com/pub.10.1038/s41393-018-0163-2

DOI

http://dx.doi.org/10.1038/s41393-018-0163-2

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1104539468

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/29895883


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