Factors predictive of survival and cumulative survival rate following spinal cord injury in Hong Kong - A retrospective study in Kowloon Hospital

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Authors (including presenting author) :
Lee YT (1), Ng HP (1), Chan HL (1), To TS (1), Cheung PCL (2), Cheng KHW(2), Li KK (2), Li W (2)
Affiliation :
(1)Department of Occupational Therapy, Kowloon Hospital (2)Department of Orthopaedics & Traumatology, Queen Elizabeth Hospital
Introduction :
Spinal cord injury (SCI) is a detrimental condition that leads to life-long changes. A survival analysis of SCI patients is important to evaluating rehabilitation outcomes and allocating resources. Local studies of this topic are lacking and this study aims to identify factors predictive of survival after spinal cord injury in Hong Kong.
Objectives :
To investigate independent factors predicting survival of local SCI patients
Methodology :
Cox proportional hazards regression analysis of 436 SCI patients discharged from Kowloon Hospital was used to investigate the association between SCI survival and multiple predictive variables, including age, gender, type of injury, severity of injury, level of injury, functional independence measure (FIM), bladder function and discharge destination.
Result & Outcome :
Independent predictive factors of decreased survival were increased age (per 10 years, hazard ratio (HR(95%CI)), 1.58(1.36-1.82); Institutional care upon discharge 2.01(1.37-2.94); inability to self-void, 1.53(1.02-2.28) and FIM score less than 54 (maximal assistance to dependent in daily activities), 1.694 (1.03-2.79). Kaplan-Meier analysis showed significant difference (p=0.000) between survival rate of SCI patients with different FIM score. The cumulative survival rate of patient with FIM lower or higher than 54 were 52% and 84% at 5-year, 37% and 73% at 10-year respectively. The results showed that older age, inability to empty bladder, institutional care and dependency in daily activities were significant independent predictors affecting survival of SCI patients discharged from our center. Enhancement of post-discharge support to patients with these characteristics may improve their survival.

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