Excess burden of a chronic disabling condition: life lost due to traumatic spinal cord injury in a Swiss population-based cohort study

Int J Public Health. 2019 Sep;64(7):1097-1105. doi: 10.1007/s00038-019-01265-6. Epub 2019 May 30.

Abstract

Objectives: To estimate excess mortality and life years lost in a Swiss cohort of individuals with traumatic spinal cord injury (TSCI).

Methods: This study uses population-based data collected in the Swiss Spinal Cord Injury Cohort (SwiSCI) study, which covers all specialized rehabilitation centres. Flexible parametric survival models were used to model life years remaining (LYR), potential years life lost (PYLL), relative survival and excess hazard ratios.

Results: Men and women with TSCI and an attained age of 30 were estimated to have 42 LYR (95% CI = 37.9-45.5) and 43 LYR (95% CI = 40.1-45.5), respectively; this equates to a life expectancy (LE) of 80.6 and 76.9% of that of the Swiss general population. With respect to lesion level and completeness, persons with incomplete paraplegia had 45.1 LYR at an attained age of 30, whereas individuals with complete tetraplegia only had 28.7 LYR. This pattern was similar for PYLL.

Conclusions: The extended LE following TSCI, even for the most severe lesions, underscores the need for sustained follow-up to support functioning and health for individuals ageing with SCI.

Keywords: Burden; Excess mortality; Life expectancy; Mortality; Potential years life lost; Spinal cord injury.

MeSH terms

  • Adult
  • Aged
  • Cohort Studies
  • Databases, Factual
  • Female
  • Humans
  • Life Expectancy*
  • Male
  • Middle Aged
  • Paraplegia / mortality
  • Proportional Hazards Models
  • Spinal Cord Injuries / mortality*
  • Survival Analysis
  • Trauma Severity Indices