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Suicide Mortality After Spinal Cord Injury in the United States: Injury Cohorts Analysis

Published:October 24, 2013DOI:https://doi.org/10.1016/j.apmr.2013.10.007

      Abstract

      Objectives

      To compare 12-year suicide-specific mortalities of 3 different injury cohorts, identify the risk factors for suicide mortality after spinal cord injury (SCI), and investigate whether suicide mortality is higher among those with SCI than in the general population.

      Design

      Retrospective cohort study.

      Setting

      United States hospitals (n=28) designated as SCI Model Systems.

      Participants

      Participants (N=31,339) injured between January 1, 1973, and December 31, 1999.

      Interventions

      Not applicable.

      Main Outcome Measure

      Suicide death after SCI.

      Results

      The crude annual suicide mortality rate during the first 12 years after SCI was 91 per 100,000 person-years for 1973 to 1979 injury cohort, 69 per 100,000 person-years for 1980 to 1989 injury cohort, and 46 per 100,000 person-years for 1990 to 1999 injury cohort. Suicide mortality was associated with race, injury severity, and years since injury. The standardized mortality ratios for the 3 cohorts were 5.2, 3.7, and 3.0, respectively.

      Conclusions

      Suicide mortality among those with SCI decreased over 3 injury cohorts, but it still remained 3 times higher than that of the general population.

      Keywords

      List of abbreviations:

      AIS (American Spinal Injury Association Impairment Scale), NSCISC (National Spinal Cord Injury Statistical Center), SCI (spinal cord injury), SCIMS (Spinal Cord Injury Model Systems), SMR (standardized mortality ratio), U.S. (United States)
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