Survival after nontraumatic spinal cord lesions in Israel

Ronen J, Goldin D, Bluvshtein V, Fishel B, Gelernter I, Catz A. Survival after nontraumatic spinal cord lesions in Israel. Arch Phys Med Rehabil 2004;85:1499-502. Objective To assess survival in patients with nontraumatic spinal cord lesions (SCL). Design Retrospective cohort study. Setting Spinal department at a rehabilitation hospital in Israel. Participants Patients with nontraumatic SCL (N=1085) admitted between 1962 and 2000. Interventions Demographic, clinical, and mortality data were collected from hospital charts and from the Population Registry of the Israel Ministry of Internal Affairs. Main Outcome Measures Survival rates and mortality risk factors. Measures were estimated by using the product limit (Kaplan-Meier) method and the Cox model. Results Maximal survival time was 57 years. Median accumulated survival time was 24 years. Survival was significantly affected by lesion etiology, age, gender, severity of lesion, and recent decade of lesion onset; survival tended to be shorter in patients with higher level SCL. We found no significant difference between the effects of risk factors on mortality in nontraumatic SCL and traumatic SCL, other than the effect of age at lesion onset, which was a greater risk factor in the latter group. Conclusions The survival rate of patients with nontraumatic SCL has improved significantly in Israel in the last decade. The survival rates of a mixed nontraumatic SCL population are similar to those of traumatic SCL but may differ in specific etiologic age groups.