Economic factors and longevity in spinal cord injury: a reappraisal.

Abstract:

OBJECTIVE:To review and reassess the findings of Krause and colleagues on the effect of economic and other risk factors on life expectancy after spinal cord injury, using an expanded and updated database. DESIGN:Pooled person-year analysis. SETTING:Model Spinal Cord Injury Systems hospitals. PARTICIPANTS:A total of 7331 persons injured since 1973 who were enrolled in the National Spinal Cord Injury Database and received an evaluation between November 1995 and December 2005. INTERVENTIONS:Not applicable. MAIN OUTCOME MEASURES:Mortality, determined by routine follow-up supplemented by information from the Social Security Death Index. Logistic regression models based on the predictor variables were developed to estimate the chance of dying in a given year. RESULTS:As in the Krause study, life expectancies of persons with the greatest handicap in economic self-sufficiency were substantially shorter than average. However, the positive effect of favorable economics was much less than previously reported, largely because having health insurance coverage through workers' compensation was no longer a powerful (or statistically significant) predictor of survival. CONCLUSIONS:The beneficial effect of favorable economics appears to be much less than previously reported. Further, the interpretation of the effects of modifiable factors (such as economics and social integration) is complicated by questions of cause and effect.

journal_name

Arch Phys Med Rehabil

authors

Strauss D,DeVivo M,Shavelle R,Brooks J,Paculdo D

doi

10.1016/j.apmr.2007.11.025

subject

Has Abstract

pub_date

2008-03-01 00:00:00

pages

572-4

issue

3

eissn

0003-9993

issn

1532-821X

pii

S0003-9993(07)01839-4

journal_volume

89

pub_type

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