Psychologic Factors and Risk of Mortality After Spinal Cord Injury

James S. Krause, Rickey E. Carter, Yusheng Zhai, Karla Reed

Research output: Contribution to journalArticle

27 Citations (Scopus)

Abstract

Krause JS, Carter R, Zhai Y, Reed K. Psychologic factors and risk of mortality after spinal cord injury. Objective: To identify the association of 2 distinct psychologic constructs, personality and purpose in life (PIL), with risk of early mortality among persons with spinal cord injury (SCI). Design: Prospective cohort study with health data collected in late 1997 and early 1998 and mortality status ascertained in December 2005. Setting: A large rehabilitation hospital in the southeastern United States. Participants: Adults (N=1386) with traumatic SCI, at least 1 year postinjury. Interventions: Not applicable. Main Outcome Measures: We first evaluated the significance of a single psychologic predictor (a total of 6 scales) while controlling for biographic and injury predictors using Cox proportional hazards modeling and subsequently built a comprehensive model based on an optimal group of psychologic variables. Results: There were a total of 224 (16.2%) observed deaths in the full sample. The total number of deaths was reduced to 164 in the final statistical model (of 1128 participants) because of missing data. All 6 psychologic factors were statistically significant in the model that was adjusted for biographic and injury factors, whereas only 3 psychologic factors were retained in the final comprehensive model, including 2 personality scales (Impulsive Sensation Seeking, Neuroticism-Anxiety) and the PIL scale. The final comprehensive model only modestly improved the overall prediction of survival compared with the model with only biographic and injury variables, because the pseudo-R2 increased from 0.121 to 0.129, and the concordance increased from 0.730 to 0.747. Conclusions: The results affirm the importance of psychologic factors in relation to survival after SCI.

Original languageEnglish (US)
Pages (from-to)628-633
Number of pages6
JournalArchives of Physical Medicine and Rehabilitation
Volume90
Issue number4
DOIs
StatePublished - Apr 2009
Externally publishedYes

Fingerprint

Spinal Cord Injuries
Mortality
Personality
Wounds and Injuries
Southeastern United States
Survival
Statistical Models
Cohort Studies
Rehabilitation
Anxiety
Outcome Assessment (Health Care)
Prospective Studies
Health

Keywords

  • Mortality
  • Personality
  • Rehabilitation
  • Risk
  • Spinal cord injuries

ASJC Scopus subject areas

  • Rehabilitation
  • Physical Therapy, Sports Therapy and Rehabilitation

Cite this

Psychologic Factors and Risk of Mortality After Spinal Cord Injury. / Krause, James S.; Carter, Rickey E.; Zhai, Yusheng; Reed, Karla.

In: Archives of Physical Medicine and Rehabilitation, Vol. 90, No. 4, 04.2009, p. 628-633.

Research output: Contribution to journalArticle

Krause, James S. ; Carter, Rickey E. ; Zhai, Yusheng ; Reed, Karla. / Psychologic Factors and Risk of Mortality After Spinal Cord Injury. In: Archives of Physical Medicine and Rehabilitation. 2009 ; Vol. 90, No. 4. pp. 628-633.
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