Survival after spinal cord injury in Finland

OBJECTIVE: Mortality, cause of death and risk indicators for death among patients with traumatic spinal cord injury were investigated over a 30-year period. DESIGN: A cross-sectional study with retrospective data. SUBJECTS: All patients (n = 1647) aged 16 years and over who had sustained traumatic spinal cord injury during the period 1976-2005, who were admitted to Käpylä Rehabilitation Centre, Helsinki, Finland, participated in the study. METHODS: Demographic and clinical data were collected from the registers of Käpylä Rehabilitation Centre. Cause-specific mortality was assessed using Statistics Finland's official cause-of-death register. RESULTS: During the observation period (1976-2007) 419 patients died. The main causes of death were respiratory disease (28%), cardiovascular disease (21%), suicide (10%) and external causes (9.5%). The mean age at death was 55.5 years for men and 58.2 years for women. Ten-year survival was 97.9%. Mortality was significantly affected by age at onset of injury, neurological level and extent of lesion. Survival of traumatic spinal cord injury patients was approximately 50% that of the general population, and survival of the general population was 80% during the follow-up period. CONCLUSION: These results support the need for improvements in long-term rehabilitative care and regular follow-up of patients with traumatic spinal cord injury. The importance of psychosocial follow-up services must be emphasized.