Survival after traumatic spinal cord injury in Denmark: a hospital-based study among patients injured in 1990–2012

Study design: Hospital-based cohort study at Spinal Cord Injury Centre of Western Denmark (VCR). Objective: To examine the overall survival and mortality over time adjusted for age at the time of injury and gender. Methods: Review of medical records of traumatic spinal cord injury (TSCI) patients admitted at VCR between 1990 and 2012. The patients were followed up until death, emigration or end of study (December 2014). Survival and mortality rate ratios (MRRs) with 95% confidence intervals (CI) were estimated for sub-groups defined by year of injury (1990–1994, 1995–1999, 2000–2004, 2005–2009 and 2010–2012). Mortality was analysed using Cox proportional hazard regression. Adjustment for gender and age at injury was performed (restricted cubic splines). Results: In total, 665 patients (males 82%) were followed; 136 (20%) patients died during the observation period. Two-year survival varied from 93% in 2005–2009 to 98% in 2000–2004. Using 1990–1994 as a reference, the adjusted MRRs varied between 1.22 (CI: 0.43; 3.42) and 0.48 (CI: 0.13; 2.71). The 5- and 10-year survival varied between 85% (2005–2009) and 95% (1990–1994), and between 77% (2005–2009) and 91% (1990–1994), respectively. No trend over time was observed either for 2-, 5- or 10-year survival. Men’s mortality did not differ consistently from that of women. Except for the most recent time period, the overall survival after TSCI was higher among those aged <60 years at time of injury. Conclusion: Survival after TSCI in Denmark did not change considerably from 1990 to 2014, and there seemed to be no gender difference. Mortality was highest among patients above 60 years of age at injury.