Predictors of cardiopulmonary hospitalization in chronic spinal cord injury.
OBJECTIVE
To investigate longitudinal risk factors of hospitalization for circulatory and pulmonary diseases among veterans with chronic spinal cord injury (SCI). Circulatory and respiratory system illnesses are leading causes of death in patients with chronic SCI, yet risk factors for related hospitalizations have not been characterized.


METHODS
Prospective cohort study.


METHODS
Veterans Affairs (VA) Boston Healthcare System, Boston, Massachusetts. PARTICIPANTS/DATA SOURCES: Veterans (N=309) greater than or equal to 1 year post-SCI from the VA Boston Chronic SCI cohort who completed a health questionnaire and underwent spirometry at study entry. Baseline data were linked to 1996 through 2003 hospitalization records from the VA National Patient Care Database.


METHODS
Not applicable.


METHODS
Cardiopulmonary hospital admissions, the predictors of which were assessed by multivariate Cox regression.


RESULTS
Of 1478 admissions observed, 143 were a result of cardiopulmonary (77 circulatory and 66 respiratory) illnesses. Independent predictors were greater age (3% increase/y), hypertension, and the lowest body mass index quintile (<22.4 kg/m2). A greater percentage-predicted forced expiratory volume in 1 second was associated with reduced risk. SCI level and completeness of injury were not statistically significant after adjusting for these risk factors.


CONCLUSIONS
Cardiopulmonary hospitalization risk in persons with chronic SCI is related to greater age and medical factors that, if recognized, may result in strategies for reducing future hospitalizations.
Waddimba
Anthony C
AC
Research and Development Service, VA Boston Healthcare System, Boston, MA.
Jain
Nitin B
NB
Stolzmann
Kelly
K
Gagnon
David R
DR
Burgess
James F
JF
Kazis
Lewis E
LE
Garshick
Eric
E
D000367:Age Factors; D000704:Analysis of Variance; D015992:Body Mass Index; D002908:Chronic Disease; D005260:Female; D015438:Health Behavior; D006331:Heart Diseases / Q000150:complications*; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D008171:Lung Diseases / Q000150:complications*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012129:Respiratory Function Tests; D012307:Risk Factors; D012959:Socioeconomic Factors; D013119:Spinal Cord Injuries / Q000150:complications*; D014481:United States; D014493:United States Department of Veterans Affairs