title: Suicide mortality after spinal cord injury in the United States: injury cohorts analysis.
abstract: OBJECTIVE
  To compare 12-year suicide-specific mortalities of 3 different injury cohorts, identify the risk factors for suicide mortality after spinal cord injury (SCI), and investigate whether suicide mortality is higher among those with SCI than in the general population.
  
  
  METHODS
  Retrospective cohort study.
  
  
  METHODS
  United States hospitals (n=28) designated as SCI Model Systems.
  
  
  METHODS
  Participants (N=31,339) injured between January 1, 1973, and December 31, 1999.
  
  
  METHODS
  Not applicable.
  
  
  METHODS
  Suicide death after SCI.
  
  
  RESULTS
  The crude annual suicide mortality rate during the first 12 years after SCI was 91 per 100,000 person-years for 1973 to 1979 injury cohort, 69 per 100,000 person-years for 1980 to 1989 injury cohort, and 46 per 100,000 person-years for 1990 to 1999 injury cohort. Suicide mortality was associated with race, injury severity, and years since injury. The standardized mortality ratios for the 3 cohorts were 5.2, 3.7, and 3.0, respectively.
  
  
  CONCLUSIONS
  Suicide mortality among those with SCI decreased over 3 injury cohorts, but it still remained 3 times higher than that of the general population.
authors.affiliation: Department of Health Sciences and Research, Medical University of South Carolina, Charleston, SC. Electronic address: caoyu@musc.edu.
authors.forename: Yue
authors.initials: Y
authors.lastname: Cao
authors.affiliation: Department of Health Sciences and Research, Medical University of South Carolina, Charleston, SC.
authors.forename: James F
authors.initials: JF
authors.lastname: Massaro
authors.affiliation: Department of Health Sciences and Research, Medical University of South Carolina, Charleston, SC.
authors.forename: James S
authors.initials: JS
authors.lastname: Krause
authors.affiliation: Department of Physical Medicine and Rehabilitation, University of Alabama-Birmingham, Birmingham, AL.
authors.forename: Yuying
authors.initials: Y
authors.lastname: Chen
authors.affiliation: Department of Physical Medicine and Rehabilitation, University of Alabama-Birmingham, Birmingham, AL.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Devivo
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D012189:Retrospective Studies; D012307:Risk Factors; D013119:Spinal Cord Injuries / Q000523:psychology*; D013405:Suicide / Q000706:statistics & numerical data*; D014481:United States / Q000453:epidemiology
keywords: AIS; American Spinal Injury Association Impairment Scale; Mortality; NSCISC; National Spinal Cord Injury Statistical Center; Rehabilitation; SCI; SCIMS; SMR; Spinal Cord Injury Model Systems; Spinal cord injuries; Suicide; U.S.; United States; spinal cord injury; standardized mortality ratio