Predictors of Cardiopulmonary Hospitalization in Chronic Spinal Cord Injury

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.