Long-term Survival of Veterans With Traumatic Spinal Cord Injury

Samsa, Gregory P.; Patrick, Clifford H.; Feussner, John R.

doi:10.1001/archneur.1993.00540090018005

Cited by 97 publications

(64 citation statements)

References 14 publications

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“…11,12 Briefly, although subjects with SCI are more likely than the able-bodied to have short expiratory efforts and exhibit excessive back extrapolation during testing, we have demonstrated that the FEV 1 and FVC of such efforts are highly reproducible. 11,12 Maximum expiratory and inspiratory pressures (MEP, MIP) were measured three times using a pressure transducer and strip chart recorder or computerized data acquisition unit and maximal values reported.…”

Section: Assessment Of Baseline Risk Factorsmentioning

confidence: 69%

“…After adjusting for age, MIP, MEP, and FEV 1 /FVC were not related to mortality, but percent-predicted FEV 1 and percent-predicted FVC were. Age-adjusted models for FEV 1 and FVC indicated that for each percent predicted increase in lung function, mortality decreased by 3% (Table 4). …”

Section: Cigarette Smokingmentioning

confidence: 99%

“…[1][2][3][4][5][6][7][8] The most common causes of death in the first year and thereafter in contemporary studies are pneumonia and other respiratory illnesses. 2,4,5,7,8 Based on retrospective assessments, excess mortality after SCI has been attributed to neurological level and completeness of injury, older age at injury, and injury in earlier calendar years.…”

Section: Introductionmentioning

confidence: 99%

“…2,4,5,7,8 Based on retrospective assessments, excess mortality after SCI has been attributed to neurological level and completeness of injury, older age at injury, and injury in earlier calendar years. [1][2][3]7,8 Risk factors for mortality have never been assessed prospectively in subjects with chronic SCI.…”

Section: Introductionmentioning

confidence: 99%

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A prospective assessment of mortality in chronic spinal cord injury

et al. 2005

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Study design: Prospective mortality study. Objective: To assess the relationship between comorbid medical conditions and other healthrelated factors to mortality in chronic spinal cord injury (SCI). Setting: Boston, MA, USA. Methods: Between 1994 and 2000, 361 males X1 year after injury completed a respiratory health questionnaire and underwent pulmonary function testing. Cause-specific mortality was assessed over a median of 55.6 months (range 0.33-74.4 months) through 12/31/2000 using the National Death Index. Results: At entry, mean (7SD) age was 50.6715.0 years (range 23-87) and years since injury was 17.5712.8 years (range 1.0-56.5). Mortality was elevated (observed/expected deaths ¼ 37/ 25.1; SMR ¼ 1.47; 95% CI ¼ 1.04-2.03) compared to US rates. Risk factors for death were diabetes (RR ¼ 2.62; 95% CI ¼ 1.19-5.77), heart disease (RR ¼ 3.66; 95% CI ¼ 1.77-7.78), reduced pulmonary function, and smoking. The most common underlying and contributing causes of death were diseases of the circulatory system (ICD-9 390-459) in 40%, and of the respiratory system in 24% (ICD-9 460-519). Conclusions: These results suggest that much of the excess mortality in chronic SCI is related to potentially treatable factors. Recognition and treatment of cardiovascular disease, diabetes, and lung disease, together with smoking cessation may substantially reduce mortality in chronic SCI.Spinal Cord (2005) 43, 408-416.

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Section: Assessment Of Baseline Risk Factorsmentioning

confidence: 69%

Section: Cigarette Smokingmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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A prospective assessment of mortality in chronic spinal cord injury

et al. 2005

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“…Our study has several surprising and important ®ndings, including the high percentage of individuals dying at a relatively young age and the signi®cant di erences in occupational status after the injury between the two groups. Other authors 13,14 have described the completeness of the injury as a ecting mortality, but the di erences were not apparent in this relatively small cohort. In our study those who died participated less in physical activity.…”

Section: Discussionmentioning

confidence: 55%

Long-term morbidity and mortality after spinal cord injury: 50 years of follow-up

et al. 2000

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Objective: To determine the long-term mortality rate and the types of morbidity among all people with spinal cord injuries (SCI) that occurred during the 1948 Israel War of Independence. Method: Chart review and telephone interviews for collecting demographic data, injury characteristics, marital status, physical activities, employment, morbidity and mortality. Results: Twenty individuals with SCI (19 males, one female). There was no regular follow-up during the ®rst 20 years post injury. The most frequent morbidities were genito-urinary, cardiovascular and decubiti. Ten (50%) had died during this overall follow-up interval. The average age at death was 60 years. The cause of death was cardiovascular in six, neoplastic disease in two, pneumonia in one, and one died from an unknown cause. Conclusions:The data analysis showed that those who died participated less in physical activity and fewer were employed as compared to the survivors.

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Baroreceptor sensitivity response to phase IV of the Valsalva maneuver in spinal cord injury

Grimm

Almenoff

Bauman

et al. 1998

Clinical Autonomic Research

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Due to the increased prevalence of ischemic heart disease and hypertension reported in individuals with chronic spinal cord injury (SCI), we investigated whether subjects with low level SCI (paraplegia), without apparent evidence of coronary artery disease, exhibit normal baroreceptor and autonomic function. Eighteen males participated in this study: seven normotensive with paraplegia, five hypertensive with paraplegia and six normotensive non-SCI controls. The Valsalva maneuver was performed by maintaining a pressure of 40 mmHg over 15 s and R-R intervals (RRI) and arterial blood pressure were measured continuously. Phase IV of the Valsalva maneuver was determined by linear regression analysis between RRI and systolic pressure, with a final slope calculated. The power spectra for RRI and blood pressure variability parameters were also analyzed, in addition to the index alpha, a frequency domain estimate of the overall gain in baroreceptor control of the RRI-arterial blood pressure. The normotensive subjects with paraplegia were found to have an impaired baroreceptor response when compared with age-matched, non-SCI controls. In addition, the levels of both the low frequency and high frequency spectral components of RRI and the index alpha were reduced in these individuals at rest. These cumulative findings strongly suggest that the integrity of the sinoaortic baroreceptors, as well as efferent parasympathetic function, may be compromised in otherwise apparently healthy individuals with chronic paraplegia.

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Long-term Survival of Veterans With Traumatic Spinal Cord Injury

Cited by 97 publications

References 14 publications

A prospective assessment of mortality in chronic spinal cord injury

A prospective assessment of mortality in chronic spinal cord injury

Long-term morbidity and mortality after spinal cord injury: 50 years of follow-up

Baroreceptor sensitivity response to phase IV of the Valsalva maneuver in spinal cord injury

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