Krause J S, Sternberg M, Lottes S, Maides J
Crawford Research Institute, Shepherd Center, Atlanta, GA 30309, USA.
Arch Phys Med Rehabil. 1997 Aug;78(8):815-21. doi: 10.1016/s0003-9993(97)90193-3.
To identify the relative risk of mortality after spinal cord injury (SCI) as a function of level of psychosocial, vocational, and medical adjustment.
A prospective design was used: data on life adjustment was obtained at one time (1985), with subsequent survival status ascertained 11 years later (1996). Logistic regression was used to identify the relative risk of mortality given the level of adjustment on a number of predictor variables.
All participants were selected from outpatient files of a Midwestern university hospital.
A total of 345 participants with SCI completed study materials in 1985 (a 78% response rate), 330 of whom could be definitively classified in 1996 as either survivor or deceased. Of these 330 participants, 84% were alive in 1996 (n = 278) and the other 16% were deceased (n = 52).
The Life Situation Questionnaire (LSQ) was used to measure nine primary predictors related to life adjustment after SCI, including employment status and eight predictor scales: Medical Instability, Adjustment, General Satisfaction, Emotional Distress, Dependency, and Poor Health. The LSQ was also used to generate data on 34 individual items that were used in exploratory predictive analyses.
All but one of the 8 primary adjustment predictors from 1985 significantly predicted 1996 mortality status. Dependency and low overall satisfaction were among the most significant predictors of mortality.
Overall quality of life is important to the longevity of people with SCI, and comprehensive rehabilitation programs are needed to promote a level of life adjustment that maximizes longevity after SCI.
确定脊髓损伤（SCI）后死亡的相对风险，该风险是心理社会、职业和医疗适应水平的函数。
采用前瞻性设计：于1985年一次性获取生活适应数据，并于11年后（1996年）确定随后的生存状况。使用逻辑回归来确定在多个预测变量的适应水平下死亡的相对风险。
所有参与者均选自中西部大学医院的门诊病历。
共有345名脊髓损伤患者在1985年完成了研究材料（回复率为78%），其中330人在1996年可明确分类为幸存者或死亡者。在这330名参与者中，84%在1996年存活（n = 278），另外16%死亡（n = 52）。
生活状况问卷（LSQ）用于测量与脊髓损伤后生活适应相关的九个主要预测因素，包括就业状况和八个预测量表：医疗不稳定、适应、总体满意度、情绪困扰、依赖和健康状况不佳。LSQ还用于生成关于34个单独项目的数据，这些数据用于探索性预测分析。
1985年的8个主要适应预测因素中，除一个外，其余均显著预测了1996年的死亡状况。依赖和总体满意度低是死亡的最显著预测因素。
总体生活质量对脊髓损伤患者的寿命很重要，需要全面的康复计划来促进生活适应水平，以最大限度地提高脊髓损伤后的寿命。
