A 25-year prospective mortality study in the spinal cord injured patient: comparison with the long-term living paraplegic.

Herein we combine 2 studies: a 25-year prospective followup on 270 spinal cord injury patients and a more than 20-year (average 24.2 years) evaluation of 175 paraplegics. The mortality rate was 49 per cent after 25 years, with renal disease as the major cause of death (43 per cent). Vascular deaths were just as prevalent during the last 5 years of spinal cord life. There are probably several reasons why some patients have long-term survival (more than 20 years), including patient motivation (better followup), less vascular problems, less chronic decubitus and a higher percentage of lower motor neuron lesions. Patients with lower motor neuron lesions had the best bladder status associated with less upper tract deterioration.