Factors predictive of survival and estimated years of life lost in the decade following nontraumatic and traumatic spinal cord injury
B. B. Hatch, C. M. Wood-Wentz, T. M. Therneau, M. G. Walker, J. M. Payne, R. K. Reeves
Study Design: Retrospective chart review. Objectives: To identify factors predictive of survival after spinal cord injury (SCI). Setting: Tertiary care institution. Methods: Multiple-variable Cox proportional hazards regression analysis for 759 patients with SCI (535 nontraumatic and 221 traumatic) included age, sex, completeness of injury, level of injury, functional independence measure (FIM) scores, rehabilitation length of stay and SCI cause. Estimated years of life lost in the decade after injury was calculated for patients vs uninjured controls. Results: Median follow-up was 11.4 years. Population characteristics included paraplegia, 58%; complete injury, 11%; male sex, 64%; and median rehabilitation length of stay, 16 days. Factors independently predictive of decreased survival were increased age (+10 years; hazard ratio (HR (95% CI)), 1.6 (1.4-1.7)), male sex (1.3 (1.0-1.6)), lower dismissal FIM score (-10 points; 1.3 (1.2-1.3)) and all nontraumatic causes. Metastatic cancer had the largest decrease in survival (HR (95% CI), 13.3 (8.7-20.2)). Primary tumors (HR (95% CI), 2.5 (1.7-3.8)), vascular (2.5 (1.6-3.8)), musculoskeletal/stenosis (1.7 (1.2-2.5)) and other nontraumatic SCI (2.3 (1.5-3.6)) were associated with decreased survival. Ten-year survival was decreased in nontraumatic SCI (mean (s.d.), 1.8 (0.3) years lost), with largest decreases in survival for metastatic cancer and spinal cord ischemia. Conclusions: Age, male sex and lower dismissal FIM score were associated with decreased survival, but neither injury severity nor level was associated with it. Survival after SCI varies depending on SCI cause, with survival better after traumatic SCI than after nontraumatic SCI. Metastatic cancer and vascular ischemia were associated with the greatest survival reduction.
https://doi.org/10.1038/sc.2016.182
10.1038/sc.2016.182
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Spinal Cord Injuries Medicine & Life Sciences 100%
Rehabilitation Medicine & Life Sciences 16%
Length of Stay Medicine & Life Sciences 15%
Spinal Cord Ischemia Medicine & Life Sciences 14%
Population Characteristics Medicine & Life Sciences 12%
Hatch, B. B., Wood-Wentz, C. M., Therneau, T. M., Walker, M. G., Payne, J. M., & Reeves, R. K. (2017). Factors predictive of survival and estimated years of life lost in the decade following nontraumatic and traumatic spinal cord injury. Spinal Cord, 55(6), 540-544. https://doi.org/10.1038/sc.2016.182
Factors predictive of survival and estimated years of life lost in the decade following nontraumatic and traumatic spinal cord injury. / Hatch, B. B.; Wood-Wentz, C. M.; Therneau, T. M.; Walker, M. G.; Payne, J. M.; Reeves, R. K.
In: Spinal Cord, Vol. 55, No. 6, 01.06.2017, p. 540-544.
Hatch, BB, Wood-Wentz, CM, Therneau, TM, Walker, MG, Payne, JM & Reeves, RK 2017, 'Factors predictive of survival and estimated years of life lost in the decade following nontraumatic and traumatic spinal cord injury', Spinal Cord, vol. 55, no. 6, pp. 540-544. https://doi.org/10.1038/sc.2016.182
Hatch BB, Wood-Wentz CM, Therneau TM, Walker MG, Payne JM, Reeves RK. Factors predictive of survival and estimated years of life lost in the decade following nontraumatic and traumatic spinal cord injury. Spinal Cord. 2017 Jun 1;55(6):540-544. https://doi.org/10.1038/sc.2016.182
Hatch, B. B. ; Wood-Wentz, C. M. ; Therneau, T. M. ; Walker, M. G. ; Payne, J. M. ; Reeves, R. K. / Factors predictive of survival and estimated years of life lost in the decade following nontraumatic and traumatic spinal cord injury. In: Spinal Cord. 2017 ; Vol. 55, No. 6. pp. 540-544.
@article{71da93f098df481fa86e1103663e3c35,
title = "Factors predictive of survival and estimated years of life lost in the decade following nontraumatic and traumatic spinal cord injury",
abstract = "Study Design: Retrospective chart review. Objectives: To identify factors predictive of survival after spinal cord injury (SCI). Setting: Tertiary care institution. Methods: Multiple-variable Cox proportional hazards regression analysis for 759 patients with SCI (535 nontraumatic and 221 traumatic) included age, sex, completeness of injury, level of injury, functional independence measure (FIM) scores, rehabilitation length of stay and SCI cause. Estimated years of life lost in the decade after injury was calculated for patients vs uninjured controls. Results: Median follow-up was 11.4 years. Population characteristics included paraplegia, 58%; complete injury, 11%; male sex, 64%; and median rehabilitation length of stay, 16 days. Factors independently predictive of decreased survival were increased age (+10 years; hazard ratio (HR (95% CI)), 1.6 (1.4-1.7)), male sex (1.3 (1.0-1.6)), lower dismissal FIM score (-10 points; 1.3 (1.2-1.3)) and all nontraumatic causes. Metastatic cancer had the largest decrease in survival (HR (95% CI), 13.3 (8.7-20.2)). Primary tumors (HR (95% CI), 2.5 (1.7-3.8)), vascular (2.5 (1.6-3.8)), musculoskeletal/stenosis (1.7 (1.2-2.5)) and other nontraumatic SCI (2.3 (1.5-3.6)) were associated with decreased survival. Ten-year survival was decreased in nontraumatic SCI (mean (s.d.), 1.8 (0.3) years lost), with largest decreases in survival for metastatic cancer and spinal cord ischemia. Conclusions: Age, male sex and lower dismissal FIM score were associated with decreased survival, but neither injury severity nor level was associated with it. Survival after SCI varies depending on SCI cause, with survival better after traumatic SCI than after nontraumatic SCI. Metastatic cancer and vascular ischemia were associated with the greatest survival reduction.",
author = "Hatch, {B. B.} and Wood-Wentz, {C. M.} and Therneau, {T. M.} and Walker, {M. G.} and Payne, {J. M.} and Reeves, {R. K.}",
note = "Publisher Copyright: {\textcopyright} 2017 International Spinal Cord Society.",
doi = "10.1038/sc.2016.182",
journal = "Spinal Cord",
T1 - Factors predictive of survival and estimated years of life lost in the decade following nontraumatic and traumatic spinal cord injury
AU - Hatch, B. B.
AU - Wood-Wentz, C. M.
AU - Therneau, T. M.
AU - Walker, M. G.
AU - Payne, J. M.
AU - Reeves, R. K.
N1 - Publisher Copyright: © 2017 International Spinal Cord Society.
N2 - Study Design: Retrospective chart review. Objectives: To identify factors predictive of survival after spinal cord injury (SCI). Setting: Tertiary care institution. Methods: Multiple-variable Cox proportional hazards regression analysis for 759 patients with SCI (535 nontraumatic and 221 traumatic) included age, sex, completeness of injury, level of injury, functional independence measure (FIM) scores, rehabilitation length of stay and SCI cause. Estimated years of life lost in the decade after injury was calculated for patients vs uninjured controls. Results: Median follow-up was 11.4 years. Population characteristics included paraplegia, 58%; complete injury, 11%; male sex, 64%; and median rehabilitation length of stay, 16 days. Factors independently predictive of decreased survival were increased age (+10 years; hazard ratio (HR (95% CI)), 1.6 (1.4-1.7)), male sex (1.3 (1.0-1.6)), lower dismissal FIM score (-10 points; 1.3 (1.2-1.3)) and all nontraumatic causes. Metastatic cancer had the largest decrease in survival (HR (95% CI), 13.3 (8.7-20.2)). Primary tumors (HR (95% CI), 2.5 (1.7-3.8)), vascular (2.5 (1.6-3.8)), musculoskeletal/stenosis (1.7 (1.2-2.5)) and other nontraumatic SCI (2.3 (1.5-3.6)) were associated with decreased survival. Ten-year survival was decreased in nontraumatic SCI (mean (s.d.), 1.8 (0.3) years lost), with largest decreases in survival for metastatic cancer and spinal cord ischemia. Conclusions: Age, male sex and lower dismissal FIM score were associated with decreased survival, but neither injury severity nor level was associated with it. Survival after SCI varies depending on SCI cause, with survival better after traumatic SCI than after nontraumatic SCI. Metastatic cancer and vascular ischemia were associated with the greatest survival reduction.
AB - Study Design: Retrospective chart review. Objectives: To identify factors predictive of survival after spinal cord injury (SCI). Setting: Tertiary care institution. Methods: Multiple-variable Cox proportional hazards regression analysis for 759 patients with SCI (535 nontraumatic and 221 traumatic) included age, sex, completeness of injury, level of injury, functional independence measure (FIM) scores, rehabilitation length of stay and SCI cause. Estimated years of life lost in the decade after injury was calculated for patients vs uninjured controls. Results: Median follow-up was 11.4 years. Population characteristics included paraplegia, 58%; complete injury, 11%; male sex, 64%; and median rehabilitation length of stay, 16 days. Factors independently predictive of decreased survival were increased age (+10 years; hazard ratio (HR (95% CI)), 1.6 (1.4-1.7)), male sex (1.3 (1.0-1.6)), lower dismissal FIM score (-10 points; 1.3 (1.2-1.3)) and all nontraumatic causes. Metastatic cancer had the largest decrease in survival (HR (95% CI), 13.3 (8.7-20.2)). Primary tumors (HR (95% CI), 2.5 (1.7-3.8)), vascular (2.5 (1.6-3.8)), musculoskeletal/stenosis (1.7 (1.2-2.5)) and other nontraumatic SCI (2.3 (1.5-3.6)) were associated with decreased survival. Ten-year survival was decreased in nontraumatic SCI (mean (s.d.), 1.8 (0.3) years lost), with largest decreases in survival for metastatic cancer and spinal cord ischemia. Conclusions: Age, male sex and lower dismissal FIM score were associated with decreased survival, but neither injury severity nor level was associated with it. Survival after SCI varies depending on SCI cause, with survival better after traumatic SCI than after nontraumatic SCI. Metastatic cancer and vascular ischemia were associated with the greatest survival reduction.
U2 - 10.1038/sc.2016.182
DO - 10.1038/sc.2016.182
JO - Spinal Cord
JF - Spinal Cord