title: Skin Ulcers and Mortality Among Adolescents and Young Adults With Spina Bifida in South Carolina During 2000-2010.
abstract: The authors investigated 48 deaths (7% death rate) among 690 adolescents and young adults with spina bifida in South Carolina during 2000-2010. The authors used Medicaid and other administrative data and a retrospective cohort design that included people with spina bifida identified using ICD-9 codes. Cox regression models with time-dependent and time-invariant covariates, and Kaplan-Meier survival curves were constructed. The authors found that 21.4% of the study group had a skin ulcer during the study period and individuals with skin ulcers had significantly higher mortality than those without ulcers (P < .0001). People who had their first skin ulcer during adolescence had higher mortality than those who had the first skin ulcer during young adulthood (P = .0002; hazard ratio = 10.70, 95% confidence interval for hazard ratio: 3.01, 38.00) and those without skin ulcers, controlling for other covariates. This study showed that age at which individuals first had a skin ulcer was associated with mortality.
authors.affiliation: Department of Epidemiology and Biostatistics, University of South Carolina Arnold School of Public Health, Columbia, SC, USA BOCAI@mailbox.sc.edu.
authors.forename: Bo
authors.initials: B
authors.lastname: Cai
authors.affiliation: Department of Epidemiology and Biostatistics, University of South Carolina Arnold School of Public Health, Columbia, SC, USA.
authors.forename: Suzanne
authors.initials: S
authors.lastname: McDermott
authors.affiliation: Department of Epidemiology and Biostatistics, University of South Carolina Arnold School of Public Health, Columbia, SC, USA.
authors.forename: Yinding
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Division of Research and Statistics, South Carolina Revenue and Fiscal Affairs, Columbia, SC, USA.
authors.forename: Julie A
authors.initials: JA
authors.lastname: Royer
authors.affiliation: Department of Family and Preventive Medicine, University of South Carolina School of Medicine, Columbia, SC, USA.
authors.forename: Joshua R
authors.initials: JR
authors.lastname: Mann
authors.affiliation: Department of Epidemiology and Biostatistics, University of South Carolina Arnold School of Public Health, Columbia, SC, USA.
authors.forename: James W
authors.initials: JW
authors.lastname: Hardin
authors.affiliation: Department of Economics, University of South Carolina, Moore School of Business, Columbia, SC, USA.
authors.forename: Orgul
authors.initials: O
authors.lastname: Ozturk
authors.affiliation: Centers for Disease Control and Prevention, National Center on Birth Defects and Developmental Disabilities, Atlanta, GA, USA.
authors.forename: Lijing
authors.initials: L
authors.lastname: Ouyang
mesh_terms: D000293:Adolescent; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012883:Skin Ulcer / Q000150:complications* / Q000401:mortality*; D013022:South Carolina / Q000453:epidemiology; D016135:Spinal Dysraphism / Q000150:complications* / Q000401:mortality*; D055815:Young Adult
keywords: Adolescent; health; skin ulcer; spina bifida; survival analysis; young adult