Associations with chest illness and mortality in chronic spinal cord injury

作者:Danilack Valery A*; Stolzmann Kelly L; Gagnon David R; Brown Robert; Tun Carlos G; Morse Leslie R; Garshick Eric
来源:Journal of Spinal Cord Medicine, 2014, 37(6): 662-669.
DOI:10.1179/2045772313Y.0000000144

摘要

Objective: Identify factors associated with chest illness and describe the relationship between chest illness and mortality in chronic spinal cord injury (SCI).
Design: Cross-sectional survey assessing chest illness and a prospective assessment of mortality.
Methods: Between 1994 and 2005, 430 persons with chronic SCI (mean +/- SD), 52.0 +/- 14.9 years old, and >= 4 years post SCI (20.5 +/- 12.5 years) underwent spirometry, completed a health questionnaire, and reported any chest illness resulting in time off work, indoors, or in bed in the preceding 3 years. Deaths through 2007 were identified.
Outcome measures: Logistic regression assessing relationships with chest illness at baseline and Cox regression assessing the relationship between chest illness and mortality.
Results: Chest illness was reported by 139 persons (32.3%). Personal characteristics associated with chest illness were current smoking (odds ratio = 2.15; 95% confidence interval = 1.25-3.70 per each pack per day increase), chronic obstructive pulmonary disease (COPD) (3.52; 1.79-6.92), and heart disease (2.18; 1.14-4.16). Adjusting for age, subjects reporting previous chest illness had a non-significantly increased hazard ratio (HR) for mortality (1.30; 0.88-1.91). In a multivariable model, independent predictors of mortality were greater age, SCI level and completeness of injury, diabetes, a lower %-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; 0.77-1.73).
Conclusion: 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.

  • 出版日期2014-11