Acute respiratory tract infection visits of veterans with spinal cord injuries and disorders: rates, trends, and risk factors.
OBJECTIVE
Respiratory complications are a major cause of illness and death in persons with spinal cord injuries and dysfunction (SCI&Ds). The objectives of this study were to examine rates of outpatient visits over 5 years for acute respiratory tract infections (ARIs), including pneumonia and influenza (P&I), lower respiratory tract infections (LRIs), and upper respiratory tract infections (URIs), in veterans with SCI&Ds and to determine whether individual characteristics were associated with the number of annual visits for each type of ARI.


METHODS
This was a longitudinal (fiscal years 1998-2002) study of ARI visits at the Veterans Health Administration (VA) in 18,693 veterans with SCI&Ds. To examine the associations between time, patient characteristics, and annual number of ARI visits, we used random effect negative binomial models.


RESULTS
Veterans with SCI&Ds had a total of 11,113 ARI visits over the 5-year period. There was a slightly decreasing trend for LRI visits over time (P < 0.01) but no significant change for other ARIs over time. There were 30 to 35 pneumonia visits and 21 to 30 acute bronchitis visits per 1,000 SCI&D veterans per year. Older veterans were more likely than younger to have P&I visits and less likely to have URI visits (P < 0.01). Veterans with paraplegia had fewer P&I visits than subjects with tetraplegia (IRR = 0.58; Cl = 0.51-0.67).


CONCLUSIONS
Visit rates for ARIs are stable for veterans with SCI&Ds. Identifying risk factors associated with ARI visits is an important first step to improve prevention and treatment of ARIs and to improve the health of veterans with SCI&Ds.
Smith
Bridget M
BM
Department of Veterans Affairs, Spinal Cord Injury Quality Enhancement Research Initiative (SCI QUERI), Edward Hines Jr VA Hospital, Hines, Illinois 60141, USA. Bridget.Smith@va.gov
Evans
Charlesnika T
CT
Kurichi
Jibby E
JE
Weaver
Frances M
FM
Patel
Nayna
N
Burns
Stephen P
SP
D000328:Adult; D000368:Aged; D000553:Ambulatory Care / Q000706:statistics & numerical data; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D012141:Respiratory Tract Infections / Q000150:complications* / Q000453:epidemiology*; D012189:Retrospective Studies; D012307:Risk Factors; D013119:Spinal Cord Injuries / Q000150:complications* / Q000453:epidemiology*; D014481:United States; D014493:United States Department of Veterans Affairs; D014728:Veterans