MORTALITY AFTER SPINAL-CORD INJURY - AN 11-YEAR PROSPECTIVE-STUDY

Objective: To identify the relative risk of mortality after spinal cor d injury (SCI) as a function of level of psychosocial, vocational, and medical adjustment. Design: A prospective design was used: data on li fe adjustment was obtained at one time (1985), with subsequent surviva l status ascertained 11 years later (1996). Logistic regression was us ed to identify the relative risk of mortality given the level of adjus tment on a number of predictor variables. Setting: All participants we re selected from outpatient files of a Midwestern university hospital. Participants: A total of 345 participants with SCI completed study ma terials in 1985 (a 78% response rate), 330 of whom could be definitive ly classified in 1996 as either survivor or deceased. Of these 330 par ticipants, 84% were alive in 1996 (n = 278) and the other 16% were dec eased (n = 52). Main Outcome Measurements: The Life Situation Question naire (LSQ) was used to measure nine primary predictors related to lif e adjustment after SCI, including employment status and eight predicto r scales: Medical Instability, Adjustment, General Satisfaction, Emoti onal Distress, Dependency, and Poor Health, The LSQ was also used to g enerate data on 34 individual items that were used in exploratory pred ictive analyses. Results: All but one of the 8 primary adjustment pred ictors from 1985 significantly predicted 1996 mortality status. Depend ency and low overall satisfaction were among the most significant pred ictors of mortality. Conclusions: Overall quality of life is important to the longevity of people with SCI, and comprehensive rehabilitation programs are needed to promote a level of life adjustment that maximi zes longevity after SCI. (C) 1997 by the American Congress of Rehabili tation Medicine and the American Academy of Physical Medicine and Reha bilitation.