TY - JOUR
T1 - Predictors of Cardiopulmonary Hospitalization in Chronic Spinal Cord Injury
AU - Waddimba, Anthony C.
AU - Jain, Nitin B.
AU - Stolzmann, Kelly
AU - Gagnon, David R.
AU - Burgess, James F.
AU - Kazis, Lewis E.
AU - Garshick, Eric
N1 - Funding Information:
Supported by the National Institutes of Health/National Institute of Child Health and Human Development (grant no. R01 HD42141; Garshick), and the Office of Research and Development, Health Services Research and Development, and Massachusetts Veterans Epidemiology Research Information Center Cooperative Studies Program, Department of Veterans Affairs.
PY - 2009/2
Y1 - 2009/2
N2 - Waddimba AC, Jain NB, Stolzmann K, Gagnon DR, Burgess JF, Kazis LE, Garshick E. Predictors of cardiopulmonary hospitalization in chronic spinal cord injury. Objective: To investigate longitudinal risk factors of hospitalization for circulatory and pulmonary diseases among veterans with chronic spinal cord injury (SCI). Circulatory and respiratory system illnesses are leading causes of death in patients with chronic SCI, yet risk factors for related hospitalizations have not been characterized. Design: Prospective cohort study. Setting: Veterans Affairs (VA) Boston Healthcare System, Boston, Massachusetts. Participants/Data Sources: Veterans (N=309) greater than or equal to 1 year post-SCI from the VA Boston Chronic SCI cohort who completed a health questionnaire and underwent spirometry at study entry. Baseline data were linked to 1996 through 2003 hospitalization records from the VA National Patient Care Database. Interventions: Not applicable. Main Outcome Measures: Cardiopulmonary hospital admissions, the predictors of which were assessed by multivariate Cox regression. Results: Of 1478 admissions observed, 143 were a result of cardiopulmonary (77 circulatory and 66 respiratory) illnesses. Independent predictors were greater age (3% increase/y), hypertension, and the lowest body mass index quintile (<22.4kg/m2). A greater percentage-predicted forced expiratory volume in 1 second was associated with reduced risk. SCI level and completeness of injury were not statistically significant after adjusting for these risk factors. Conclusions: Cardiopulmonary hospitalization risk in persons with chronic SCI is related to greater age and medical factors that, if recognized, may result in strategies for reducing future hospitalizations.
AB - Waddimba AC, Jain NB, Stolzmann K, Gagnon DR, Burgess JF, Kazis LE, Garshick E. Predictors of cardiopulmonary hospitalization in chronic spinal cord injury. Objective: To investigate longitudinal risk factors of hospitalization for circulatory and pulmonary diseases among veterans with chronic spinal cord injury (SCI). Circulatory and respiratory system illnesses are leading causes of death in patients with chronic SCI, yet risk factors for related hospitalizations have not been characterized. Design: Prospective cohort study. Setting: Veterans Affairs (VA) Boston Healthcare System, Boston, Massachusetts. Participants/Data Sources: Veterans (N=309) greater than or equal to 1 year post-SCI from the VA Boston Chronic SCI cohort who completed a health questionnaire and underwent spirometry at study entry. Baseline data were linked to 1996 through 2003 hospitalization records from the VA National Patient Care Database. Interventions: Not applicable. Main Outcome Measures: Cardiopulmonary hospital admissions, the predictors of which were assessed by multivariate Cox regression. Results: Of 1478 admissions observed, 143 were a result of cardiopulmonary (77 circulatory and 66 respiratory) illnesses. Independent predictors were greater age (3% increase/y), hypertension, and the lowest body mass index quintile (<22.4kg/m2). A greater percentage-predicted forced expiratory volume in 1 second was associated with reduced risk. SCI level and completeness of injury were not statistically significant after adjusting for these risk factors. Conclusions: Cardiopulmonary hospitalization risk in persons with chronic SCI is related to greater age and medical factors that, if recognized, may result in strategies for reducing future hospitalizations.
KW - Cardiovascular system
KW - Hospitalization
KW - Proportional hazards models
KW - Rehabilitation
KW - Respiratory system
KW - Spinal cord injuries
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U2 - 10.1016/j.apmr.2008.07.026
DO - 10.1016/j.apmr.2008.07.026
M3 - Article
C2 - 19236973
AN - SCOPUS:60349084872
SN - 0003-9993
VL - 90
SP - 193
EP - 200
JO - Archives of Physical Medicine and Rehabilitation
JF - Archives of Physical Medicine and Rehabilitation
IS - 2
ER -