Health Services Research & Development

Veterans Crisis Line Badge
Go to the ORD website
Go to the QUERI website

2007 HSR&D National Meeting Abstract

Printable View

National Meeting 2007

3086 — Causes of Death for Veterans with Spinal Cord Injuries and Disorders

Smith BG (MCHSPR/SCI QUERI) , Weaver FM (MCHSPR/SCI QUERI), LaVela SL (MSCHPR/SCI QUERI), Miskevics SA (MCHSPR/SCI QUERI), Evans CE (MCHSPR/SCI QUERI)

Objectives:
There are 225,000 to 296,000 persons with spinal cord injuries and disorders (SCI&D) in the US, and approximately 22% are veterans. Most persons with SCI&D need life-long health care to address the functioning limitations, secondary complications, and other effects of their conditions. Additional information about causes of death is necessary in order to understand these needs. The objective of this study was to determine the most frequent causes of mortality for veterans with SCI&D.

Methods:
2,468 veterans with SCI&D who died between October 1, 1999 and September 30, 2001 and who had an identifiable cause of death were included. Underlying and contributing causes of death were obtained from National Death Index (NDI) data; patient characteristics were obtained from VA national databases. Frequencies and logistic regression analyses were used to describe the data and to examine the relationship between age, race, and cause of death.

Results:
The most common underlying causes of death for veterans with SCI&D were heart disease (25%), malignant neoplasms (22%), accidents (9%), and chronic respiratory disease (5%). These were also the most frequent contributing causes, in addition to other diseases of the respiratory system (8%) and influenza and pneumonia (6.4%). Increasing age was statistically associated with a higher probability of dying from heart disease (OR=1.02, 95% CI: 1.02 – 1.03, p<0.0001) and with a lower probability of dying from accidents (OR=0.96, 95% CI: 0.95 – 0.97, p<0.0001). White veterans had a higher probability of having a chronic respiratory disease as an underlying cause than other veterans (OR=2.18, 95% CI: 1.27 – 3.74, p=0.0047).

Implications:
The most frequent causes of death for veterans with SCI&D during this time period were heart disease, cancer, accidents, and respiratory diseases infections. For younger veterans with SCI&D, accidents were the most frequent cause of mortality.

Impacts:
Ongoing work is being conducted to focus on treatment and prevention of respiratory complications in veterans with SCI&D. Future research should focus on heart disease and cancer in this population, as well as on preventing accidents for the younger veterans with SCI.