Associations with chest illness and mortality in chronic spinal cord injury
Model System:
SCIReference Type:
JournalAccession No.:
J70178Journal:
Journal of Spinal Cord Medicine - JSCM (formerly Journal of the American Paraplegia Society)
Year, Volume, Issue, Page(s):
, 37, 6, 662-669Publication Website:
Abstract:
Study identified factors associated with chest illness and examined relationship between chest illness and mortality in chronic spinal cord injury (SCI). Between 1994 and 2005, 430 adults at least 4 years post SCI, with a mean age of 52 years, underwent spirometry, completed a health questionnaire, and reported any chest illness resulting in time off work, indoors at home, or in bed in the preceding 3 years. Deaths through 2007 were identified. Logistic regression assessed relationships with chest illness at baseline and Cox regression assessed the relationship between chest illness and mortality. Chest illness was reported by 139 participants (32.3 percent). Personal characteristics associated with chest illness were current smoking, chronic obstructive pulmonary disease (COPD), and heart disease. Adjusting for age, subjects reporting previous chest illness had a non-significantly increased hazard ratio (HR) for mortality (1.30). In a multivariable model, independent predictors of mortality were greater age, SCI level and completeness of injury, diabetes, a lower percent-predicted forced expiratory volume in 1 second, heart disease, and smoking history. Adjusting for these covariates, the effect of a previous chest illness on mortality was attenuated (HR = 1.15). In chronic SCI, chest illness in the preceding 3 years was not an independent risk factor for mortality and was not associated with level and completeness of SCI, but was associated with current smoking, physician-diagnosed COPD, and heart disease history.