Factors affecting long-term mortality rate after diagnosis of syringomyelia in disabled spinal cord injury patients: a population-based study

Spinal Cord. 2020 Apr;58(4):402-410. doi: 10.1038/s41393-019-0363-4. Epub 2019 Oct 10.

Abstract

Study design: A retrospective, population-based study.

Objectives: To identify factors affecting long-term mortality and medical resources use in disabled spinal cord injury (SCI) patients after syringomyelia diagnosis.

Setting: A National Health Insurance Research Database containing 10,374 patients with SCI.

Methods: Data recorded between 1997 and 2012 for 376 disabled SCI patients with syringomyelia and 376 characteristics-matched disabled SCI patients without syringomyelia were collected. The index date was the date of syringomyelia diagnosis. Cox proportional hazards regression model was used to investigate the factors affecting 10-year mortality in these patients. Medical resources use was compared for 1 year before and after index date.

Results: The survival rate at 10-year follow-up after syringomyelia diagnosis was estimated at 68.6%. The 10-year survival rate was comparable between the two groups. Age ≥ 60 (adjusted hazard ratios (aHR) 4.21, 95% confidence interval (CI) 2.97 to 5.96) and < 30 years (aHR 0.25, 95% CI 0.10 to 0.62), spinal cord or spinal canal operations within 1 year after the index date (aHR 1.84, 95% CI 1.19 to 2.84), history of pneumonia (aHR 1.55, 95% CI 1.07 to 2.26), and history of coronary heart disease (CHD) (aHR 1.85, 95% CI 1.18 to 2.89) were significantly associated with long-term mortality. Outpatient prescription costs were higher during 1 year after the diagnosis than those of 1 year before the diagnosis.

Conclusion: Age, spinal operations, history of pneumonia, and history of CHD are associated with 10-year mortality in disabled SCI patients with syringomyelia.

MeSH terms

  • Adult
  • Age Factors
  • Comorbidity
  • Coronary Disease / epidemiology*
  • Databases, Factual
  • Disabled Persons / statistics & numerical data*
  • Female
  • Humans
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Neurosurgical Procedures / statistics & numerical data*
  • Pneumonia / epidemiology*
  • Retrospective Studies
  • Spinal Cord Injuries / complications
  • Spinal Cord Injuries / epidemiology*
  • Spinal Cord Injuries / surgery
  • Syringomyelia / diagnosis
  • Syringomyelia / etiology
  • Syringomyelia / mortality*