Mortality after spinal cord injury in Norway.
OBJECTIVE
To study mortality, cause of death and risk indicators for death in Norwegian patients with spinal cord injury.


METHODS
A cross-sectional study with retrospective data.


METHODS
All patients (n=387) with traumatic spinal cord injury admitted to Sunnaas Rehabilitation Hospital, Norway, during the period 1961-82.


METHODS
Medical records were reviewed retrospectively. Causes of death were collected from Statistics Norway and death certificates. Standardized mortality ratios (SMRs) were calculated for the entire sample and for causes of death. To explore risk indicators for death, a Cox regression model was used.


RESULTS
During the observation period, 1961-2002, 142 patients died. The main causes of death were pneumonia/influenza (16%), ischaemic heart diseases (13%) and urogenital diseases (13%). SMR was 1.8 for men and 4.9 for women. Cause-specific SMRs were markedly elevated for urogenital diseases, suicide, pneumonia/influenza, urogenital cancer, and diseases of the digestive system. Risk indicators for death were: higher age at injury, tetraplegia, functionally complete spinal cord injury, pre-injury cardiovascular disease, alcohol or substance abuse and psychiatric diagnosis.


CONCLUSIONS
The SMRs show that life expectancy is reduced in chronic spinal cord injury in Norway, more for women than for men. Cause-specific SMRs and risk indicators suggest that the high mortality rates after spinal cord injury to a certain degree are related to preventable aetiologies. To maximize longevity in chronic spinal cord injury, more attention must be paid to co-morbidity.
Lidal
Ingeborg Beate
IB
Sunnaas Rehabilitation Hospital, Faculty Division Ullevaal University Hospital, University of Oslo, pb 1130 Blindern, Oslo, Norway. ingeborg.lidal@sunnaas.no
Snekkevik
Hildegun
H
Aamodt
Geir
G
Hjeltnes
Nils
N
Biering-Sørensen
Fin
F
Stanghelle
Johan Kvalvik
JK
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D002423:Cause of Death; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008017:Life Expectancy; D008297:Male; D008875:Middle Aged; D009664:Norway / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors; D013119:Spinal Cord Injuries / Q000150:complications / Q000401:mortality*