Chest
Clinical Investigations in Critical CareLife Expectancy of Ventilator-Dependent Persons With Spinal Cord Injuries
Section snippets
Study Population
This study was conducted on 435 persons who sustained a traumatic SCI between 1973 and 1992 that resulted in ventilator dependency, who survived at least 24 h after injury, and who were admitted within 1 year of injury to a federally designated model regional SCI care system located throughout the United States (the identity of each facility appears in the acknowledgment). All persons either remained ventilator dependent at the time of discharge from rehabilitation or died prior to discharge
Results
The mean and SD age at injury of the entire study population was 39.6 ± 22.6 years. Median age at injury was 33 years. The comparable mean and median ages at injury for the overall spinal cord injury population are 30.5 ± 14.9 years and 26 years, respectively.35 Therefore, persons who sustain SCI resulting in ventilator dependency are on average, slightly older than those who do not require ventilators. Typical of SCI in general, 81.4% of the study population were men, 75.4% were white, 18.2%
Discussion
This study provides the most up-to-date, complete, and accurate information currently available about long-term survival and causes of death for a relatively large sample of ventilator-dependent persons followed up prospectively for several years by the model SCI care systems. Perhaps the most striking and by far the most encouraging finding is the substantial improvement in survival rates that has occurred since the inception of the model SCI care system program, particularly among persons who
Acknowledgment
The authors express their sincere appreciation to project directors and data coordinators at the following institutions that submitted data to this collaborative study: The University of Alabama at Birmingham; Rancho Los Amigos Medical Center, Downey, Calif; Craig Hospital, Englewood, Colo; Shepherd Center for Treatment of Spinal Injuries, Inc, Atlanta; Northwestern University Medical Center and Rehabilitation Institute of Chicago; Boston University Medical Center; Rehabilitation Institute of
References (45)
- et al.
Mortality, survival and prevalence: traumatic spinal cord injury in Olmsted County, Minnesota, 1935-1981
J Chronic Dis
(1985) - et al.
Survival from spinal cord injury
J Chronic Dis
(1982) - et al.
Survival with an acute spinal cord injury
J Chronic Dis
(1979) A 25-year prospective mortality study in the spinal cord injured patient: comparison with the long-term living paraplegic
J Urol
(1977)- et al.
Long-term outlook in quadriplegic patients with initial ventilator dependency
Chest
(1986) - et al.
Maximum utilization of the life table method in analyzing survival
J Chronic Dis
(1958) - et al.
Incidence of respiratory complications following spinal cord injury
Arch Phys Med Rehabil
(1994) - et al.
Respiratory complications and management of spinal cord injuries
Chest
(1990) - et al.
Pneumococcal vaccination for patients with spinal cord injury
Arch Phys Med Rehabil
(1993) - et al.
Life satisfaction and well-being measures in ventilator assisted individuals with traumatic tetraplegia
Arch Phys Med Rehabil
(1994)
Causes of death during the first 12 years after spinal cord injury
Arch Phys Med Rehabil
Long-term survival of veterans with traumatic spinal cord injury
Arch Neurol
Prognostic factors for 12-year survival after spinal cord injury
Arch Phys Med Rehabil
Mortality, morbidity, and psychosocial outcomes of persons spinal cord injured more than 20 years ago
Paraplegia
Mortality after spinal cord injury: a 4-year prospective study
Arch Phys Med Rehabil
Cause of death for patients with spinal cord injuries
Arch Intern Med
Initial factors predicting survival in patients with a spinal cord injury
J Neurol Neurosurg Psychiatry
Seven-year survival following spinal cord injury
Arch Neurol
Prediction of long-term survival of persons with spinal cord injury: an 11-year prospective study
Rehabil Psychol
A 15-year follow-up of 406 consecutive spinal cord injuries
Br J Urol
Survival in traumatic spinal cord injury
Paraplegia
Life expectancy following spinal cord injury: a 10-year survey in the Rhone-Alpes region, France, 1969-1980
Paraplegia
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2019, Respiratory Physiology and NeurobiologyCitation Excerpt :Consequently, high-cervical SCIs frequently cause respiratory failure, necessitating mechanical ventilation. Increased mortality due to lung infections occurs in ventilator-dependent patients following SCI (DeVivo and Ivie, 1995). On the other hand, mid- and low-cervical SCIs partially spare phrenic motor neurons; nevertheless, there is still potential for respiratory impairment and reliance on ventilatory support depending on the extent of spared neural tissue following injury.
Supported by grant H133N00001-93 from the National Institute on Disability and Rehabilitation Research (NIDRR), Department of Education, Washington, DC.