Mortality after spinal cord injury: a four-year prospective study.

Research has suggested that mortality after spinal cord injury (SCI) is correlated with lower levels of social and vocational activities and lower life satisfaction. The purpose of this study was to use prospective data from a 1985 SCI follow-up study to identify predictors of survival status four years later. In 1985, responses to the revised Life Situation Questionnaire were obtained from 347 participants with SCI. Survival status was ascertained in 1989; 89% (n = 309) were known to be alive and 6% (n = 22) were deceased. Multivariate ANOVA was used to compare the surviving and deceased participant groups using the 1985 data. Results suggested that survivors had superior adjustment on many of the variables tested in 1985. In particular, the survivors were more active, rated their adjustment as better, were more satisfied with many areas of life, and reported fewer problems (especially with emotional distress). Recent medical history (ie, nonroutine doctor visits and hospitalizations) was not related to survival. This study reaffirms the importance of psychologic, social, and vocational variables as predictors of survival. A call is made for rehabilitation psychologists to address tough issues (eg, substance abuse) and to thoroughly study more specific health behaviors as they relate to survival after SCI.