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HSR&D Citation Abstract

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Causes of Death for Veterans with Spinal Cord Injuries and Disorders

Smith BM, Weaver FM, LaVela SL, Miskevics SA, Evans CT. Causes of Death for Veterans with Spinal Cord Injuries and Disorders. Paper presented at: VA HSR&D National Meeting; 2007 Feb 22; Arlington, VA.

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Objectives: There are 225,000 to 296,000 persons with spinal cord injuries and disorders (SCIandD) in the US, and approximately 22% are veterans. Most persons with SCIandD 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 SCIandD. Methods: 2,468 veterans with SCIandD 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 SCIandD 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 SCIandD during this time period were heart disease, cancer, accidents, and respiratory diseases infections. For younger veterans with SCIandD, 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 SCIandD. Future research should focus on heart disease and cancer in this population, as well as on preventing accidents for the younger veterans with SCI.

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