Madasa V1, Joseph C2,3, Boggenpoel B4, Phillips J3,4
1University of the Western Cape, Faculty of Community and Health Sciences, Physiotherapy, Bellville, South Africa, 2University of Western Cape, Physiotherapy, Bellville, South Africa, 3Karolinska Institutet, Physiotherapy, Stockholm, Sweden, 4University of the Western Cape, Physiotherapy, Bellville, South Africa
Background: A spinal cord injury (SCI) results in a change, either temporary or permanent, in the cord's normal motor, sensory or autonomic function. These changes predispose people who survive the initial injury to premature death. Previous studies have indicated that the mortality rate among the spinal cord community remains higher when compared to the general population, however, data pertaining to South Africa are lacking.
Purpose: To determine the mortality rate and risk indicators of mortality at four years post traumatic spinal cord injury in the City of Cape Town, South Africa.
Methods: A prospective, regional population-based study design was used. The study population consisted of all participants with TSCI who were enrolled in an earlier incidence study that was conducted in 2013/2014. For the follow-up study an inclusive sampling strategy was used. Descriptive statistics was used to describe the cohort and to present the mortality rate. Inferential statistics, i.e. bivariate logistic regression analysis, was used to identify factors associated with mortality.
Results: A total number of 55 persons (63%) were alive and completed the full survey, 21 persons (24%) had demised by the 4 years post injury inquiry, and 11 people (13%) were classified as alive but not reachable/ “missing" during the data collection period.: Of those forming part of the study, the mortality rate was 24% four years post injury. The main cause of death reported was death due to septicaemia (n=7; 33%) followed by unknown cause of death (n=7; 33%), death due to pressure ulcers (n=5; 24%), and the least common cause of death reported was death classified as other with persons (n=2; 9.5%) reported other causes of death (stomach cancer, natural cause Persons with an incomplete injury were four times less likely to die (OR: 0.2; 95% confidence interval (CI): 0.07-0.58) and those having transport related injuries were at almost nine times less risk of death in comparison to falls (OR: 0.11; 95%CI: 0.01-0.76).
Conclusion(s): The study revealed that almost one quarter of persons with TSCI have died four years post injury. The significant risk indicators for mortality were completeness of injury and aetiology. A better understanding of why those with complete injuries and those having their SCI due to falls is required in order to develop prevention strategies.
Implications: The results of the study could be used to appropriately allocate resources in healthcare, for people with TSCI, in South Africa in order to improve their chances of survival. Improving the longevity of people with TSCI will enable physiotherapists to play a critical role in maintaining and improving functioning that is necessary for living a full and productive life.
Keywords: Mortality, TSCI, Risk-indicators
Funding acknowledgements: The South African Medical Research Council provided funding for this phase of the study to be carried out.
Purpose: To determine the mortality rate and risk indicators of mortality at four years post traumatic spinal cord injury in the City of Cape Town, South Africa.
Methods: A prospective, regional population-based study design was used. The study population consisted of all participants with TSCI who were enrolled in an earlier incidence study that was conducted in 2013/2014. For the follow-up study an inclusive sampling strategy was used. Descriptive statistics was used to describe the cohort and to present the mortality rate. Inferential statistics, i.e. bivariate logistic regression analysis, was used to identify factors associated with mortality.
Results: A total number of 55 persons (63%) were alive and completed the full survey, 21 persons (24%) had demised by the 4 years post injury inquiry, and 11 people (13%) were classified as alive but not reachable/ “missing" during the data collection period.: Of those forming part of the study, the mortality rate was 24% four years post injury. The main cause of death reported was death due to septicaemia (n=7; 33%) followed by unknown cause of death (n=7; 33%), death due to pressure ulcers (n=5; 24%), and the least common cause of death reported was death classified as other with persons (n=2; 9.5%) reported other causes of death (stomach cancer, natural cause Persons with an incomplete injury were four times less likely to die (OR: 0.2; 95% confidence interval (CI): 0.07-0.58) and those having transport related injuries were at almost nine times less risk of death in comparison to falls (OR: 0.11; 95%CI: 0.01-0.76).
Conclusion(s): The study revealed that almost one quarter of persons with TSCI have died four years post injury. The significant risk indicators for mortality were completeness of injury and aetiology. A better understanding of why those with complete injuries and those having their SCI due to falls is required in order to develop prevention strategies.
Implications: The results of the study could be used to appropriately allocate resources in healthcare, for people with TSCI, in South Africa in order to improve their chances of survival. Improving the longevity of people with TSCI will enable physiotherapists to play a critical role in maintaining and improving functioning that is necessary for living a full and productive life.
Keywords: Mortality, TSCI, Risk-indicators
Funding acknowledgements: The South African Medical Research Council provided funding for this phase of the study to be carried out.
Topic: Neurology: spinal cord injury
Ethics approval required: Yes
Institution: University of the Western Cape
Ethics committee: Biomedical Science Research Ethics Committee
Ethics number: BM17/6/11
All authors, affiliations and abstracts have been published as submitted.
