Journal
SPINAL CORD
Volume 50, Issue 8, Pages 609-613Publisher
NATURE PUBLISHING GROUP
DOI: 10.1038/sc.2012.24
Keywords
spinal cord injuries; socioeconomic factors; behavior; mortality; life expectancy; health status
Categories
Funding
- Department of Education
- NIDRR [H133N50022, H133G050165]
- National Institutes of Health [1R01 NS 48117]
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Objective: To evaluate the association of demographic, behavioral and socioeconomic factors with all-cause mortality while controlling for health status among a cohort of participants with severe disability related to spinal cord injury (SCI). Study design: Prospective cohort study. Setting: Data were analyzed at a major medical university in the Southeast United States of America. Methods: Participants included 1361 adults with traumatic SCI of at least 1-year duration who were recruited through a large specialty hospital in the Southeast United States of America. Three Cox proportional hazard models were generated relating the predictors to all-cause mortality. Results: Age, disability, smoking and income were significant in the final model. Both current (hazard ratio (HR)=2.03, 95% confidence interval (CI)-1.46-2.82) and former smokers (HR-1.58, CI-1.16-2.16) were at elevated hazard of mortality, as were those with incomes below $10 000 (HR=2.29, CI=1.53-3.44) and between $10 000 and $35 000 (HR=1.47, CI=1.03-2.10). Conclusions: Even after controlling for health and severity of disability, the coefficients for smoking and income were significant, exceeding that reported previously within the general population. The importance of these factors may be magnified after severe disability, even though life expectancy is already greatly diminished in this population. Spinal Cord (2012) 50, 609-613; doi:10.1038/sc.2012.24; published online 13 March 2012
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