Mortality after traumatic spinal cord injury: 50 years of follow-up
Mortality after traumatic spinal cord injury: 50 years of follow-up
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DOI：
10.1136/jnnp.2009.178798
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发表时间：
2010-04-01
影响因子：
11
通讯作者：
Gronning, Marit
中科院分区：
文献类型：
--
作者：
Hagen, Ellen Merete;Lie, Stein Atle;Gronning, Marit
目的研究1952-2001年间非特定地理位置的外伤性脊髓损伤(TSCI)患者的死亡率和死亡原因。死亡日期是从国家人口登记处获得的，死亡原因通过与挪威死因登记处的链接进行记录。使用根据年龄和性别调整的标准化死亡率比率(SMR)将患者死亡率与挪威人口的死亡率进行比较。结果确定了401名患者(70名女性和331名男性)。到2008年8月31日，有173人死亡。死亡患者的中位生存期为7.4年，颈椎损伤患者的中位生存期为6.9年，胸腰椎损伤患者的中位生存期为8.2年。与挪威人相比，TSCI患者的死亡率(SMR为1.85)更高。SMR在观察期内无明显变化。女性SMR显著高于男性(2.88比1.72)，完全性TSCI患者SMR高于不完全性TSCI患者(4.23比1.25)。颈椎完全性损伤患者SMR为6.70，TLS完全性损伤患者SMR为3.07。呼吸系统疾病的SMR为1.96，包括意外中毒在内的自杀SMR为3.70，女性为37.59。结论TSCI患者，尤其是女性，尽管采用了现代化的治疗和护理，但死亡率仍在上升。应特别注意呼吸功能障碍和肺部感染，防止自杀和意外中毒。
Objective To study mortality and causes of death in an unselected geographically defined cohort of patients with traumatic spinal cord injury (TSCI), 1952-2001.Methods Patients were identified from hospital records. The date of death was obtained from the National Population Register, and causes of death recorded by linkage to the Norwegian Cause of Death Registry. Patient mortality was compared with mortality in the Norwegian population using standardised mortality ratios (SMR) adjusted for age and gender.Results 401 patients (70 women and 331 men) were identified. By 31 August 2008, 173 were dead. Median survival time in deceased patients was 7.4 years; 6.9 years for patients with cervical injuries and 8.2 years for patients with thoracolumbosacral injuries (TLS). TSCI patients had an increased mortality (SMR 1.85) compared with the Norwegian population. SMR did not change during the observation period. SMR was significantly higher for women than for men (2.88 vs 1.72), and higher in patients with complete TSCI compared with patients with incomplete TSCI (4.23 vs 1.25). SMR was 6.70 for patients with complete cervical injuries and 3.07 for patients with complete TLS injuries. Cause specific SMR were 1.96 for respiratory disease, and for suicide including accidental poisoning 3.70 for men and 37.59 for women.Conclusions Patients with a TSCI, and especially women, have an increased mortality despite modern treatment and care. Special attention should be paid to respiratory dysfunction and pulmonary infections, and to prevent suicide and accidental poisoning.