Long-term survival of veterans with traumatic spinal cord injury
G. P. Samsa, C. H. Patrick and J. R. Feussner
Center for Health Services Research in Primary Care, Department of Veterans Affairs Medical Center, Durham, NC 27705.
OBJECTIVE--To investigate the long-term survival of veterans with traumatic
spinal cord injury (SCI). DESIGN--Survival in a retrospective inception
cohort of veterans suffering service-connected traumatic SCI is compared
with survival among veterans disabled by other conditions, survival among
nondisabled veterans, and a population-based life table. SETTING--Subjects
were identified from a national census of veterans with service-connected
disabilities, using a selection algorithm based on disability codes.
PATIENTS--A retrospective cohort of 5545 male veterans with traumatic SCI,
surviving at least 3 months after injury, is compared with a stratified
random sample of 7077 disabled veterans without SCI, a stratified random
sample of 6967 nondisabled veterans, and a life table formed from similarly
aged American males. MAIN OUTCOME MEASURE--Survival curves, extending from
3 months to 40 years after injury. RESULTS--The mean life expectancy of
veterans suffering traumatic SCI and surviving at least 3 months is an
additional 39 years after injury, 85% that of similarly aged American
males. Although survival with traumatic SCI was comparable to that of the
disabled control subjects for approximately 20 years after onset, a clear
deficit occurred beyond this point. Older age at injury is a stronger
predictor of poorer long-term survival than is complete quadriplegia.
CONCLUSIONS--Among patients who survive the acute phase of their traumatic
SCI, long-term survival is relatively good. Health care planners,
providers, and communities should anticipate an increasing number of
persons aging with SCI.
