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Published on: February 1, 2018
Long-term survival of veterans with traumatic spinal cord injury
G P Samsa1, C H Patrick, J R Feussner
1Center for Health Services Research in Primary Care, Department of Veterans Affairs Medical Center, Durham, NC 27705.
Objective:
To investigate the long-term survival of veterans with traumatic spinal cord injury (SCI).
Design:
Survival in a retrospective inception cohort of veterans suffering service-connected traumatic SCI is compared with survival among veterans disabled by other conditions, survival among nondisabled veterans, and a population-based life table.
Setting:
Subjects were identified from a national census of veterans with service-connected disabilities, using a selection algorithm based on disability codes.
Patients:
A retrospective cohort of 5545 male veterans with traumatic SCI, surviving at least 3 months after injury, is compared with a stratified random sample of 7077 disabled veterans without SCI, a stratified random sample of 6967 nondisabled veterans, and a life table formed from similarly aged American males.
Main Outcome Measure:
Survival curves, extending from 3 months to 40 years after injury.
Results:
The mean life expectancy of veterans suffering traumatic SCI and surviving at least 3 months is an additional 39 years after injury, 85% that of similarly aged American males. Although survival with traumatic SCI was comparable to that of the disabled control subjects for approximately 20 years after onset, a clear deficit occurred beyond this point. Older age at injury is a stronger predictor of poorer long-term survival than is complete quadriplegia.
Conclusions:
Among patients who survive the acute phase of their traumatic SCI, long-term survival is relatively good. Health care planners, providers, and communities should anticipate an increasing number of persons aging with SCI.

