title: Long-term survival after traumatic spinal cord injury: a 70-year British study.
abstract: METHODS
  Retrospective and prospective observational.
  
  
  OBJECTIVE
  Analyse long-term survival after traumatic spinal cord injury (SCI) in Great Britain over the 70-year study period, identify mortality risk factors and estimate current life expectancy.
  
  
  METHODS
  Two spinal centres in Great Britain.
  
  
  METHODS
  The sample consisted of patients with traumatic SCI injured 1943-2010 who survived the first year post-injury, had residual neurological deficit on discharge and were British residents. Life expectancy and trends over time were estimated by neurological grouping, age and gender, using logistic regression of person-years of follow-up combined with standard life table calculations.
  
  
  RESULTS
  For the 5483 cases of traumatic SCI the mean age at injury was 35.1 years, 79.7% were male, 31.1% had tetraplegia AIS/Frankel ABC, 41.2% paraplegia ABC,and 27.7% functionally incomplete lesion (all Ds). On 31 December 2014, 54% were still alive, 42.3% had died and 3.7% were lost to follow-up. Estimated life expectancies improved significantly between the 1950s and 1980s, plateaued during the next two decades, before slightly improving again since 2010. The estimated current life expectancy, compared with the general British population, ranged from 18.1 to 88.4% depending on the ventilator dependency, level and completeness of injury, age and gender.
  
  
  CONCLUSIONS
  Life expectancy after SCI improved significantly between the 1950s and 1980s, plateaued during the 1990s and 2000s, before slightly improving again since 2010, but still remains well below that of the general British population.
  
  
  BACKGROUND
  Buckinghamshire Healthcare NHS Trust Charitable Spinal Fund and Ann Masson Legacy for Spinal Research Fund, UK.
authors.affiliation: National Spinal Injuries Centre, Stoke Mandeville Hospital, Buckinghamshire Healthcare NHS Trust, Buckinghamshire, UK.
authors.forename: G
authors.initials: G
authors.lastname: Savic
authors.affiliation: University of Alabama at Birmingham, Birmingham, AL, USA.
authors.forename: M J
authors.initials: MJ
authors.lastname: DeVivo
authors.affiliation: National Spinal Injuries Centre, Stoke Mandeville Hospital, Buckinghamshire Healthcare NHS Trust, Buckinghamshire, UK.
authors.forename: H L
authors.initials: HL
authors.lastname: Frankel
authors.affiliation: National Spinal Injuries Centre, Stoke Mandeville Hospital, Buckinghamshire Healthcare NHS Trust, Buckinghamshire, UK.
authors.forename: M A
authors.initials: MA
authors.lastname: Jamous
authors.affiliation: North West Regional Spinal Injuries Centre, Southport Hospital, Southport and Ormskirk NHS Trust, Merseyside, UK.
authors.forename: B M
authors.initials: BM
authors.lastname: Soni
authors.affiliation: Craig Hospital, Englewood, CO, USA.
authors.forename: S
authors.initials: S
authors.lastname: Charlifue
mesh_terms: D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008017:Life Expectancy; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors; D013119:Spinal Cord Injuries / Q000453:epidemiology*; D016019:Survival Analysis; D006113:United Kingdom; D055815:Young Adult