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  4. Behavioral Risk Factors of Mortality After Spinal Cord Injury

Behavioral Risk Factors of Mortality After Spinal Cord Injury

Arch Phys Med Rehabil, 2009 · DOI: 10.1016/j.apmr.2008.07.012 · Published: January 1, 2009

Spinal Cord InjuryRehabilitationPublic Health

Simple Explanation

This study investigates how behaviors like smoking, drinking, and medication use affect how long people with spinal cord injuries (SCI) live. It looks at these behaviors in addition to factors like the severity of their injury and their age. The study found that certain behaviors, such as smoking, binge drinking, using prescription medications, and spending less time out of bed, were linked to a higher risk of death. Addressing these behaviors could help people with SCI live longer. Rehabilitation programs should consider including interventions targeting risky behaviors to improve the long-term health and survival of individuals with SCI.

Study Duration
8 Years
Participants
1386 adults with traumatic SCI
Evidence Level
Prospective cohort study

Key Findings

  • 1
    Smoking, binge drinking, prescription medication use, and less time out of bed are significant behavioral predictors of mortality after SCI.
  • 2
    Including behavioral variables in a predictive model enhances the prediction of mortality beyond biographic and injury variables alone.
  • 3
    Participants with the most severe injuries (C1-4, nonfunctional) had the greatest hazard (3.22) compared with those with the least severe injuries (ambulatory).

Research Summary

This study identified the association of risk and protective behaviors for mortality after SCI using prospective cohort design and a priori selection of variables using a general risk model. The study identified several behaviors related to risk of mortality and enhanced the prediction of mortality beyond that of simple biographic and injury related factors. The unique contribution of this study is the identification of the association of risk and protective behaviors for mortality after SCI using prospective cohort design and a priori selection of variables using a general risk model.

Practical Implications

Targeted Interventions

Rehabilitation programs should integrate interventions targeting smoking cessation, alcohol misuse, and appropriate medication management.

Risk Assessment

Clinicians should routinely assess behavioral risk factors to identify individuals at higher risk of early mortality.

Primary Care Education

Educate primary care physicians about the specific needs of individuals with SCI, including behavioral risk factors and preventative measures.

Study Limitations

  • 1
    Data were heavily left censored.
  • 2
    There were no data in the first postinjury year.
  • 3
    Causality cannot be assumed from the design.

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