Affiliations: [a] Life Expectancy Project, San Francisco, CA, USA
| [b]
University of Alabama at Birmingham, Birmingham, AL, USA
| [c]
National Spinal Injuries Centre, Stoke Mandeville Hospital, Buckinghamshire Healthcare, Aylesbury, UK
Correspondence:
[*]
Address for correspondence: Dr. Robert Shavelle, Life Expectancy Project, 1439 – 17th Avenue, San Francisco, CA, USA. E-mail: Shavelle@LifeExpectancy.org.
Abstract: BACKGROUND:Long-term survival after spinal cord injury (SCI) has been extensively studied in the US and UK. OBJECTIVE:To compare SCI epidemiology and survival results between the US and UK for the same time period and patient groups. METHODS:We restricted attention to persons injured at ages 18 and older who had survived at least 2 years post injury and were not ventilator dependent. We performed survival analysis using logistic regression on person-year data with time-dependent covariates. The resulting mortality rates were used to construct life tables in order to obtain life expectancies. RESULTS:The average age at injury, percentage male, and level/grade of injury were rather similar between the two countries. After adjustment for risk factors, UK mortality was 85% of that in the US (95% c.i. 80% to 91%, p < 0.0001). Mortality increased by 0.3% per year over the 1980 to 2012 study period (HR = 1.003); this was not statistically significant (p = 0.44). The US and UK life expectancies are nearly the same percentage of their respective general population values, differing by at most 2%. CONCLUSION:Long-term mortality after SCI in the UK is roughly 15% lower than that in the US. The general population mortality in the UK is also approximately 15% lower, however, and thus the percentages of normal life expectancy in the two countries prove to be strikingly similar.
