Apurba Barman1, Devika Shanmugasundaram2, Rohit Bhide3, Anand Viswanathan3, Henry Prakash Magimairaj3, Guru Nagarajan3, Elango Arumugam3, George Tharion3, Raji Thomas3. 1. Department of Physical Medicine and Rehabilitation, Christian Medical College, Vellore, Tamil Nadu, India; Department of Physical Medicine and Rehabilitation, All India Institute of Medical Sciences, Bhubaneswar, India. Electronic address: apurvaa23@gmail.com. 2. Department of Biostatistics, Christian Medical College, Vellore, Tamil Nadu, India. 3. Department of Physical Medicine and Rehabilitation, Christian Medical College, Vellore, Tamil Nadu, India.
Abstract
OBJECTIVE: To assess the survival in persons with traumatic spinal cord injury (SCI) receiving structured follow-up in South India. DESIGN: Retrospective study. SETTING: Rehabilitation center. PARTICIPANTS: Persons with traumatic SCI (N=490) residing within a 100-km radius of the institute who were managed and regularly followed up by the rehabilitation center between the years 1981 and 2011. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Survival rates and mortality risk factors. Measures were estimated using the product limit (Kaplan-Meier) method and the Cox model. RESULTS: The survival rate after SCI was 86% after 5 years, 71% after 15 years, and 58% after 25 years. Survival of persons with complete high cervical injury is substantially low compared with other levels of SCI. Level of injury and extent of lesion (Frankel classification and/or American Spinal Injury Association Impairment Scale) play a significant role in predicting survival of this population. CONCLUSIONS: Survival rates of regularly followed-up persons with SCI from this study show promising results, though survival rates are lesser when compared with studies from developed countries. Better understanding of the predictors, causes of deaths, comprehensive rehabilitation, community integration, and regular follow-up could possibly assist in improving survival rates.
OBJECTIVE: To assess the survival in persons with traumatic spinal cord injury (SCI) receiving structured follow-up in South India. DESIGN: Retrospective study. SETTING: Rehabilitation center. PARTICIPANTS: Persons with traumatic SCI (N=490) residing within a 100-km radius of the institute who were managed and regularly followed up by the rehabilitation center between the years 1981 and 2011. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Survival rates and mortality risk factors. Measures were estimated using the product limit (Kaplan-Meier) method and the Cox model. RESULTS: The survival rate after SCI was 86% after 5 years, 71% after 15 years, and 58% after 25 years. Survival of persons with complete high cervical injury is substantially low compared with other levels of SCI. Level of injury and extent of lesion (Frankel classification and/or American Spinal Injury Association Impairment Scale) play a significant role in predicting survival of this population. CONCLUSIONS: Survival rates of regularly followed-up persons with SCI from this study show promising results, though survival rates are lesser when compared with studies from developed countries. Better understanding of the predictors, causes of deaths, comprehensive rehabilitation, community integration, and regular follow-up could possibly assist in improving survival rates.
Authors: Mohammad Sohrab Hossain; Lisa A Harvey; Hueiming Liu; Md Shofiqul Islam; Md Akhlasur Rahman; Stephen Muldoon; Fin Biering-Sorensen; Ian D Cameron; Harvinder S Chhabra; Richard I Lindley; Stephen Jan Journal: BMJ Open Date: 2018-07-16 Impact factor: 2.692