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September 1993

Long-term Survival of Veterans With Traumatic Spinal Cord Injury

Author Affiliations

From the Center for Health Services Research in Primary Care, Department of Veterans Affairs Medical Center (Drs Samsa and Feussner), Department of Community and Family Medicine (Drs Samsa and Feussner), and Department of Medicine (Drs Samsa and Feussner), Duke University Medical Center, Durham, NC; and Office of Quality Management Planning and Evaluation, Department of Veterans Affairs, Washington, DC (Dr Patrick).

Arch Neurol. 1993;50(9):909-914. doi:10.1001/archneur.1993.00540090018005

• 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.

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