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Longitudinal changes in employment, health, participation, and quality-of-life and the relationships with long-term survival after spinal cord injury

Spinal Cord volume 61, pages 430–435 (2023)Cite this article

Subjects

Abstract

Study design

Cohort study.

Objective

To identify five-year longitudinal changes in employment, health, participation, and quality-of-life outcomes (QOL) among participants with chronic spinal cord injury (SCI) and to compare the amount of change in these outcomes between those surviving and those not surviving until follow-up.

Methods

Participants were 1157 individuals from the SCI Longitudinal Aging Study, who have completed at least two self-report assessments separated by five-year intervals. The main outcome measures were 13 indicators related to employment, health, participation, and QOL/psychosocial indicators. Survival status measured at follow-up.

Results

Those who survived to follow up had a history indicating a greater likelihood of employment, better health, participation, and QOL/psychosocial indicators. Among survivors, longitudinal declines were limited to the percent employed and participation indicators, whereas those deceased by follow-up had significant undesirable changes in employment, participation, health, and QOL/psychosocial indicators. More specifically, compared to the survivors, those deceased by follow-up experienced a greater increase in hospitalizations, decreases in nights away from home, and declines in global satisfaction over the five-year interval.

Conclusions

Longitudinal declines in employment and some aspects of participation are common among long-term survivors and may be part of the natural course of outcomes after SCI. However, more dramatic increases in hospitalizations, fewer nights away from home, and declining satisfaction may be red flags for declining longevity.

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Funding

Funding

The contents of this publication were developed under grants from the National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR) grant numbers 90IFRE0044, 90IF0112, 90IF0015, H133G060126, and H133G020239. NIDILRR is a Center within the Administration for Community Living (ACL), Department of Health and Human Services (HHS). The contents of this publication do not necessarily represent the policy of NIDILRR, ACL, HHS, and you should not assume endorsement by the Federal Government or the state of South Carolina.

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Authors and Affiliations

  1. College of Health Professions, Medical University of South Carolina, Charleston, SC, USA

    Yue Cao, Nicole D. DiPiro & James S. Krause

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  1. Yue Cao
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  3. James S. Krause
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Contributions

YC was the lead author and was responsible for the analyses, methods, and results sections, and overall development of the manuscript. ND completed the literature review and contributed to the discussion and conclusions sections. JK was the principal investigator and contributed to the discussion and conclusion sections, as well as the overall development and editing of the manuscript.

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Correspondence to Yue Cao.

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Cao, Y., DiPiro, N.D. & Krause, J.S. Longitudinal changes in employment, health, participation, and quality-of-life and the relationships with long-term survival after spinal cord injury. Spinal Cord 61, 430–435 (2023). https://doi.org/10.1038/s41393-023-00882-6

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