Frisbie 2010; USA Downs&Black = 15 Retrospective Longitudinal N=322

Population: 318 males and 4 females; had follow up service for SCI with scheduled annual checkups between 1998 and 2007.

Methodology: Cohort was divided into two groups: surviving and deceased through 2008.

Outcome Measures: prevalence rates of anemia (AN), severe anemia (SAN) and hypoalbuminemia (HA).

1. A total of 239 subjects survived to an average age of 60 and 30 years of paralysis and 83 subjects died at an average age of 70 and 27 years of paralysis.
2. The fraction of survey years that were positive for severe anemia and/or hyperalbuminia among causes of death were sepsis (42%), cancer (33%), pulmonary failur (30%), cardiovascular disease (25%), undetermined causes (9%).

Samsa et al. 1993; USA
Downs & Black = 14
Cross-sectional with AB controls
N SCI = 6147

Population: 5545 veterans with SCI, mean age at onset 23±6 yrs, 24±13 years post-injury.

Methodology: Comparison of long-term survival of veterans with SCI to a population-based life table. Life table formed from age-matched American males from same time period.

Outcome Measures: Survival curves, extending from 3 months to 40 years after injury.

1. Mean life expectancy of veterans suffering traumatic SCI and surviving at least 3 months is an additional 39 yrs after injury - 85% of age-matched American males.
2. Older age at injury is a stronger predictor of poorer long-term survival than is complete tetraplegia.

Population: 731 men and 257 women with traumatic SCI; differed significantly in age at TSCI, race and type of SCI

Methodology: Using 2 statewide datasets, prevalence and incidence of medically attended health conditions during emergency department visits, acute care hospitalizations, and outpatients hospital visits, across all ages and SCI severity over a 10 year follow-up period were reported. A time-to-event life table method was used to calculate the prevalence and incidence of health conditions and Cox proportional hazard ratio of mortality by gender controlling for age and SCI severity.

Outcome Measures: Morbidities identified by ICD-9-CM; ICDMAP-health care billing data.

1. During 10 year follow-up period, 49 (19.1%) women and 104 (14.2%) men died. No difference between genders for mortality after controlling for age and TSCI severity.
2. The reported 15.5% mortality rate is higher than other reports (7 to 9%) examining outcomes in the SCI population over a 10-year period.