Risk of Death After Hospital Discharge With Traumatic Spinal Cord Injury: A Population-Based Analysis, 1998-2009

Objective: To investigate risk factors associated with mortality among people with traumatic spinal cord injury (TSCI) after discharge from acute care hospitals in South Carolina and to compare their mortality experiences with the general population. Design: Retrospective cohort study. Setting: Sixty-two acute care, nonfederal hospitals. Participants: Persons (N=2685) with TSCI. Interventions: Not applicable. Main Outcome Measures: Death after TSCI from all causes within 4288 days of observation after discharge from acute care facilities. Results: The crude annual mortality rate during the period was 33 per 1000 person-years. Number of comorbidities, admission into trauma centers, advancing age, type of insurance, injury level and completeness, and being a man were significantly associated (P<.05) with the risk of death after discharge from acute care facilities. The overall mortality rate of our cohort is 3.6 times (95% confidence interval, 3.3-3.9) higher than the general population. Conclusions: The causes of postdischarge deaths are multifactorial, and more emphasis should be placed on managing and monitoring chronic diseases throughout the recovery process to improve the survivorship of people with TSCI. (C) 2013 by the American Congress of Rehabilitation Medicine