Jonviea D Chamberlain1,2,3, Anne Buzzell4,5, Hans Peter Gmünder6, Kerstin Hug7, Xavier Jordan8, André Moser9, Martin Schubert10, Marcel Zwahlen11, Martin W G Brinkhof4,5. 1. Swiss Paraplegic Research, Nottwil, Switzerland, jonviea.chamberlain@paraplegie.ch. 2. University of Lucerne, Health Sciences and Health Policy, Luzern, Switzerland, jonviea.chamberlain@paraplegie.ch. 3. Institute of Social and Preventative Medicine, University of Bern, Bern, Switzerland, jonviea.chamberlain@paraplegie.ch. 4. Swiss Paraplegic Research, Nottwil, Switzerland. 5. University of Lucerne, Health Sciences and Health Policy, Luzern, Switzerland. 6. Swiss Paraplegic Center, Nottwil, Switzerland. 7. REHAB Basel, Basel, Switzerland. 8. Clinique Romande de Réadaptation, Sion, Switzerland. 9. Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zürich, Switzerland. 10. Balgrist University Hospital, Zürich, Switzerland. 11. Institute of Social and Preventative Medicine, University of Bern, Bern, Switzerland.
Abstract
BACKGROUND: Traumatic spinal cord injuries (TSCI) are a neurological condition associated with reduced well-being, increased morbidity and reductions in life expectancy. Estimates of all-cause and cause-specific mortality can aid in identifying targets for prevention and management of contributors for premature mortality. OBJECTIVES: To compare all-cause and cause-specific rates of mortality to that of the Swiss general population; to identify differentials in risk of cause-specific mortality according to lesion characteristics. METHODS: All-cause and cause-specific standardized mortality ratios (SMRs) were calculated using data from the Swiss Spinal Cord Injury cohort study. Cause-specific subhazard ratios were estimated within a competing risk framework using flexible parametric survival models. RESULTS: Between 1990 and 2011, 2,492 persons sustained a TSCI, of which 379 died. Persons with TSCI had a mortality rate more than 2 times higher than that of the Swiss general population (SMR 2.32; 95% CI 2.10-2.56). Tetraplegic lesions were associated with an increased risk of mortality due to respiratory and cardiovascular diseases, infections, and accidents. Cause-specific SMRs were notably elevated for SCI-related conditions such as urinary tract infections (UTIs) and septicemia. CONCLUSIONS: Elevated SMRs due to cardiovascular disease, UTIs and septicemia-related mortality suggest the need for innovation when managing associated secondary health conditions.
BACKGROUND:Traumatic spinal cord injuries (TSCI) are a neurological condition associated with reduced well-being, increased morbidity and reductions in life expectancy. Estimates of all-cause and cause-specific mortality can aid in identifying targets for prevention and management of contributors for premature mortality. OBJECTIVES: To compare all-cause and cause-specific rates of mortality to that of the Swiss general population; to identify differentials in risk of cause-specific mortality according to lesion characteristics. METHODS: All-cause and cause-specific standardized mortality ratios (SMRs) were calculated using data from the Swiss Spinal Cord Injury cohort study. Cause-specific subhazard ratios were estimated within a competing risk framework using flexible parametric survival models. RESULTS: Between 1990 and 2011, 2,492 persons sustained a TSCI, of which 379 died. Persons with TSCI had a mortality rate more than 2 times higher than that of the Swiss general population (SMR 2.32; 95% CI 2.10-2.56). Tetraplegic lesions were associated with an increased risk of mortality due to respiratory and cardiovascular diseases, infections, and accidents. Cause-specific SMRs were notably elevated for SCI-related conditions such as urinary tract infections (UTIs) and septicemia. CONCLUSIONS: Elevated SMRs due to cardiovascular disease, UTIs and septicemia-related mortality suggest the need for innovation when managing associated secondary health conditions.
Authors: Jonviea D Chamberlain; Inge E Eriks-Hoogland; Kerstin Hug; Xavier Jordan; Martin Schubert; Martin W G Brinkhof Journal: BMJ Open Date: 2020-07-09 Impact factor: 2.692
Authors: A Buzzell; J D Chamberlain; I Eriks-Hoogland; K Hug; X Jordan; M Schubert; M Zwahlen; M W G Brinkhof Journal: Spinal Cord Date: 2019-10-07 Impact factor: 2.772
Authors: Anja M Raab; Martin W G Brinkhof; David J Berlowitz; Karin Postma; David Gobets; Sven Hirschfeld; Maria T E Hopman; Burkhart Huber; Margret Hund-Georgiadis; Xavier Jordan; Martin Schubert; Renate Wildburger; Gabi Mueller Journal: BMJ Open Date: 2020-11-05 Impact factor: 2.692