Life expectancy of ventilator-dependent persons with spinal cord injuries.

OBJECTIVE The purpose of this study is to estimate age-specific life expectancies for ventilator-dependent persons with spinal cord injury (SCI). DESIGN Nonconcurrent prospective study. SETTING Federally designated model SCI care systems. PATIENTS The study included all 435 persons admitted to a model SCI care system between 1973 and 1992 who survived at least 24 h postinjury and who were either ventilator dependent at rehabilitation discharge or who died prior to discharge while still ventilator dependent. INTERVENTION None. OUTCOME MEASURES Standardized mortality ratio (SMR), life expectancy, and causes of death. RESULTS The overall 1-year survival rate was 25.4%, while the 15-year survival rate was 16.8%. Among those who survived the first year, cumulative survival over the next 14 years was 61.4%. The mortality rate for persons injured since 1980 was reduced by 60% compared with persons injured between 1973 and 1979. Among year 1 survivors, the subsequent mortality rate was reduced by 39% for persons injured between 1980 and 1985, and 91% for persons injured since 1986, relative to persons injured between 1973 and 1979. The leading cause of death was respiratory complications, particularly pneumonia. CONCLUSIONS With the development of improved methods of prevention and management of respiratory complications in this population, life expectancies should continue to improve. As a result, additional attention should be focused on enhancing the quality of life for these individuals.