All-cause and cause-speciﬁc mortality following non-traumatic spinal cord injury: evidence from a population-based cohort study in Switzerland

Spinal Cord, 2020 · DOI: https://doi.org/10.1038/s41393-019-0361-6 · Published: October 7, 2019

Simple Explanation

This study examines the death rates and causes of death in people with non-traumatic spinal cord injuries (NTSCI) in Switzerland compared to the general population. Data from the Swiss Spinal Cord Injury (SwiSCI) study was linked with death records from the Swiss National Cohort to analyze mortality. The study found that people with NTSCI have a higher mortality rate than the general population, with cardiovascular disease, neoplasms, and infection being the most common causes of death.

Study Duration

1990-2011 (21 years)

Participants

1501 individuals with non-traumatic spinal cord injury

Evidence Level

Observational cohort study

Key Findings

1
The mortality rate for persons with NTSCI was 1.6 times greater than that of the general population in Switzerland.
2
Cardiovascular disease (39.8%), neoplasms (22%), and infection (9.9%) were the most frequently reported causes of death in individuals with NTSCI.
3
Individuals with NTSCI due to vascular etiologies showed the greatest burden of mortality from infection compared to the general population.

Research Summary

This study benchmarks all-cause and cause-speciﬁc mortality following NTSCI to the general population (GP). Cause-speciﬁc SMRs varied according to etiology. This supports the need for targeted clinical care and follow-up. Cardiovascular disease, neoplasms, and infection, emerged as main causes of death following NTSCI and should thus be targets for future research and differential clinical management approaches.

Practical Implications

Targeted Clinical Care

The study supports the need for tailored clinical care and follow-up based on the etiology of the NTSCI.

Future Research

Future research should focus on cardiovascular disease, neoplasms, and infection as key targets for reducing mortality in the NTSCI population.

Healthcare Strategies

Healthcare strategies should align NTSCI-specific treatment with care for underlying health conditions to improve morbidity and mortality outcomes.

Study Limitations

1
The study design targeted individuals that were admitted for ﬁrst rehabilitation, therefore the portion of individuals that never receive specialized rehabilitation or treatment are less represented.
2
Information on cause of death relied solely on the accuracy of reporting practices on death certiﬁcates.
3
Many CoD groups included limited cases, which were further reduced when stratiﬁed on NTSCI-speciﬁc etiological groups.

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