Survival following spinal cord infarction

Study design: Retrospective open cohort. Objectives: To calculate the survival of patients with spinal cord infarction and to compare the cause of death in patients with different mechanisms of ischaemic injury. Setting: Spinal Rehabilitation Unit, Melbourne, Victoria, Australia. Methods: Consecutive admissions between 1 January 1995 and 31 December 2008 with recent onset of spinal cord infarction. Linkage to the Registry of Births, Deaths and Marriages (Victoria) was used to determine survival following discharge from in-patient rehabilitation and cause of death. Results: A total of 44 patients were admitted (males 26, 59%), with a median age of 72 years (interquartile range (IQR) 62-79). One patient died during their in-patient rehabilitation programme. In all, 14 patients (n = 14/44; 33%) died during the follow-up period. The median survival after diagnosis was 56 months (IQR 28-85) and after discharge from in-patient rehabilitation was 46 months (IQR 25-74). The 1- and 5-year mortality rates were 7.0% (n = 3/43; 95% confidence interval (CI) = 2.4-18.6%) and 20.9% (n = 9/43; 95% CI = 11.4-35.2%). There was no statistically significant difference in survival between patients with the different aetiologies of spinal cord infarction (other vs idiopathic: chi(2) = 0.6, P = 0.7; other vs vascular: chi(2) = 1.9, P = 0.3). There was no relationship between survival and gender (chi(2) = 0.2, P = 0.6), age (chi(2) = 3.0, P = 0.08), level of injury (chi(2) = 0.0, P = 1) or American Spinal Cord Society Impairment Scale grade of spinal cord injury (chi(2) = 0.02, P = 0.9). Conclusion: Patients with spinal cord infarction appear to have a fair survival after discharge from in-patient rehabilitation, not withstanding the occurrence of risk factors of vascular disease in many patients.