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Michael J. DeVivo, DrPH; Paula L. Kartus, MPH; Samuel L. Stover, MD; Richard D. Rutt; Philip R. Fine, PhD

Arch Intern Med. 1989;149(8):1761-1766.

Abstract
• An epidemiologic study of 5131 patients sustaining spinal cord injuries between 1973 and 1980 was conducted to determine and characterize the leading causes of death in this population. Patients who were studied had been admitted to one of seven federally designated regional spinal cord injury care systems and they survived for at least 24 hours after injury. When follow-up was terminated, 459 patients (9%) had died. Overall, the leading cause of death was pneumonia, followed by other subsequent unintentional injuries and suicides. The highest ratios of actual to expected deaths were for septicemia, pulmonary emboli, and pneumonia. Pneumonia was the leading cause of death among quadriplegics and persons at least 55 years of age, while among paraplegics and persons who were less than 55 years of age, subsequent unintentional injuries and suicides were the leading causes of death. While there is conclusive evidence that mortality rates for spinal-cord injured persons have declined dramatically since the end of World War II, many cause-specific mortality rates remain substantially above normal.

(Arch Intern Med. 1989;149:1761-1766)

Author Affiliations
From the Spain Rehabilitation Center, University of Alabama at Birmingham, University Station.

Footnotes
Accepted for publication May 4,1989.

Presented, in part, at the 46th annual assembly of the American Academy of Physical Medicine and Rehabilitation, Boston, Mass, October 21-26, 1984.

Reprint requests to Spain Rehabilitation Center, University of Alabama at Birmingham, University Station, Birmingham, AL 35294 (Dr DeVivo).

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