Archives of physical medicine and rehabilitation · 2025
The Impact of Multiple Chronic Conditions on Survival in Persons With Spinal Cord Injury.
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Huang Ya-Ping, Guo Huai-Jing, Cheng Jen-Chi, Pan Shin-Liang
Аннотация
OBJECTIVE: To investigate the impact of multiple chronic conditions (MCCs) on long-term survival in persons with spinal cord injury (SCI), based on a nationally representative sample.
DESIGN: Retrospective cohort study.
SETTING: Taiwan's Longitudinal Health Insurance Database.
PARTICIPANTS: This study enrolled 2854 participants who (1) had at least 2 documented SCI diagnoses in their medical records from 2002-2006, with the first diagnosis during that period serving as the index date, and (2) were aged ≥20 years at the index date. Among these, 731 were categorized as having MCC and 2123 as non-MCC. The inclusion criterion for the MCC group was 2 or more chronic conditions at the index date.
INTERVENTIONS: Not applicable.
MAIN OUTCOME MEASURES: Mortality events.
RESULTS: In the MCC group, the mortality rate was 57.6 per 1000 person-years (95% confidence interval [CI], 50.7-65.2), whereas the non-MCC group had a mortality rate of 22.0 per 1000 person-years (95% CI, 19.7-24.5). The MCC group had a higher mortality risk, which was significant, with an adjusted hazard ratio of 1.40 (95% CI, 1.18-1.66; p=.0001).
CONCLUSIONS: This population-based longitudinal follow-up study indicates that patients with SCI and MCCs had poorer survival than those without MCCs.
DESIGN: Retrospective cohort study.
SETTING: Taiwan's Longitudinal Health Insurance Database.
PARTICIPANTS: This study enrolled 2854 participants who (1) had at least 2 documented SCI diagnoses in their medical records from 2002-2006, with the first diagnosis during that period serving as the index date, and (2) were aged ≥20 years at the index date. Among these, 731 were categorized as having MCC and 2123 as non-MCC. The inclusion criterion for the MCC group was 2 or more chronic conditions at the index date.
INTERVENTIONS: Not applicable.
MAIN OUTCOME MEASURES: Mortality events.
RESULTS: In the MCC group, the mortality rate was 57.6 per 1000 person-years (95% confidence interval [CI], 50.7-65.2), whereas the non-MCC group had a mortality rate of 22.0 per 1000 person-years (95% CI, 19.7-24.5). The MCC group had a higher mortality risk, which was significant, with an adjusted hazard ratio of 1.40 (95% CI, 1.18-1.66; p=.0001).
CONCLUSIONS: This population-based longitudinal follow-up study indicates that patients with SCI and MCCs had poorer survival than those without MCCs.