LONG-TERM SURVIVAL IN SPINAL-CORD INJURY - A 50 YEAR INVESTIGATION

The aims of this study were to examine long-term survival in a populat ion-based sample of spinal cord injury (SCI) survivors in Great Britai n, identify risk factors contributing to deaths and explore trends in cause of death over the decades following SCI. Current survival status was successfully identified in 92.3% of the study sample. Standardise d mortality ratios (SMRs) were calculated and compared with a similar USA study. Relative risk ratio analysis showed that higher mortality r isk was associated with higher neurologic level and completeness of sp inal cord injury, older age at injury and earlier year of injury. For the entire fifty year time period, the leading cause of death was rela ted to the respiratory system; urinary deaths ranked second followed b y heart disease related deaths, but patterns in causes of death change d over time. In the early decades of injury, urinary deaths ranked fir st, heart disease deaths second and respiratory deaths third. In the l ast two decades of injury, respiratory deaths ranked first, heart rela ted deaths were second, injury related deaths ranked third and urinary deaths fourth. This study also raises the question of examining alter native neurological groupings for future mortality risk analysis.