Study about Morbidity and Mortality in Chronic Spinal Cord Injury

Mortality in patients with traumatic spinal cord injury: Descriptive analysis of 62 deceased subjects Roland Thietje 1 , M.H. Pouw 3 , A.P. Schulz 2 , B. Kienast 1 , Sven Hirschfeld 1 1 Centre for Spinal Injuries, BG Trauma Hospital Hamburg, Germany, 2 Dept. of Biomechanics and Orthopaedic Research, University Hospital Lübeck, Germany, 3 Spine Unit, Department of Orthopedic Surgery, Radboud University Nijmegen Medical Centre, NL Study design: Retrospective study. Objective: To investigate the causes of death in patients who were ≤ 50 years at the time of traumatic spinal cord injury (tSCI). Setting: Convenience sample of a tertiary rehabilitation center. Methods: All deceased patients with tSCI who survived a minimum of 10 years post-injury, were included. In addition, causes of death were compared between subjects surviving < 10 years and ≥ 10 years. Neurological assessments were performed according to the American Spinal Injury Association scale. Data on causes of death were analyzed using the ICD-10 classifications. Differences were calculated using the Mann – Whitney and chi-square tests. Results: A total of 100 patients, with 38 and 62 surviving < 10 and ≥ 10 years, respectively, were included. No significant differences in causes of death were identified between these two groups. In patients surviving ≥ 10 years, paraplegia was associated with a higher life expectancy compared with tetraplegia, 34 and 25 years ( p = 0.008), respectively, and the leading causes of death were septicemia ( n = 14), ischemic heart disease ( n = 10), neoplasms ( n = 9), cerebrovascular diseases ( n = 5), and other forms of heart diseases ( n = 5). Septicemia, influenza / pneumonia, and suicide were the leading causes of death in tetraplegics, whereas ischemic heart disease, neoplasms, and septicemia were the leading causes of death in paraplegia. Conclusion: Our monocentric study showed that in 62 deceased patients with SCI, the leading causes of death were septicemia, cardiovascular diseases, neoplasms, and cerebrovascular diseases. In addition, no significant differences were identified between causes of death among patients surviving < 10 years and ≥ 10 years post-injury. Keywords: Spinal cord injuries