Purpose: To identify the relationships between health behaviors and participation and life expectancy after spinal cord injury (SCI), while controlling for biographic and injury factors. Methods: Data for this prospective cohort study were collected by mailed survey. Participants included 1,361 adults with traumatic SCI, 1 or more years post injury. Participants were enrolled an average of 9.7 years after injury, and mortality was determined at the end of 2007. There were 294 deaths by follow-up. Life expectancy was calculated utilizing person-years and logistic regression. Results: When evaluating each factor while controlling for biographic and injury characteristics, it was found that smoking history, binge drinking, number of drinks consumed, and psychotropic prescription medication use were related to increased mortality risk, whereas exercise and weekly outings were associated with a lower mortality risk. In the final model, only smoking history, binge drinking, psychotropic prescription medication use, and weekly outings were predictive of mortality and life expectancy. Conclusion: Several behaviors identified may become targets of prevention strategies to promote longevity, including smoking cessation, stopping binge drinking, avoiding overreliance on psychotropic prescription medications, and promoting daily activities away from home.

health behaviors, mortality, psychosocial, risk, spinal cord injury
DeVivo MJ, Krause JS, Lammertse DP. Recent trends in mortality and causes of death among persons with spinal cord injury. Arch Phys Med Rehabil. 1999;80(11):1411-1419.
,
Recent trends in mortality and causes of death among persons with spinal cord injury
,
Arch Phys Med Rehabil.
, vol.
80
(pg.
1411
-
1419
)
Strauss DJ, DeVivo MJ, Paculdo DR, Shavelle RM. Trends in life expectancy after spinal cord injury. Arch Phys Med Rehabil. 2006;87:1079-1085.
,
Trends in life expectancy after spinal cord injury
,
Arch Phys Med Rehabil.
, vol.
87
(pg.
1079
-
1085
)
Krause JS, DeVivo MJ, Jackson AB. Health status, community integration, and economic risk factors for mortality after spinal cord injury. Arch Phys Med Rehabil. 2004;85:1764-1773.
,
Health status, community integration, and economic risk factors for mortality after spinal cord injury
,
Arch Phys Med Rehabil.
, vol.
85
(pg.
1764
-
1773
)
National Spinal Cord Injury Statistical Center (NSCISC). Annual Statistical Report. Birmingham, AL: University of Alabama; November 2009.
,
National Spinal Cord Injury Statistical Center (NSCISC)
,
Annual Statistical Report
Krause JS. Secondary conditions and spinal cord injury: a model for prediction and prevention. Top Spinal Cord Inj Rehabil. 1996;2(2):217-227.
,
Secondary conditions and spinal cord injury: a model for prediction and prevention
,
Top Spinal Cord Inj Rehabil.
, vol.
2
(pg.
217
-
227
)
Garshick E, Kelley A, Cohen SA, et al. A prospective assessment of mortality in chronic spinal cord injury. Spinal Cord. 2005;43(7):408-416.
,
A prospective assessment of mortality in chronic spinal cord injury
,
Spinal Cord
, vol.
43
(pg.
408
-
416
)
Krause JS, Carter RE, Pickelsimer E. Behavioral risk factors of mortality after spinal cord injury. Arch Phys Med Rehabil. 2009;90(1):95-101.
,
Behavioral risk factors of mortality after spinal cord injury
,
Arch Phys Med Rehabil.
, vol.
90
(pg.
95
-
101
)
Krause JS, Zhai Y, Saunders LL, Carter RE. Risk of mortality after spinal cord injury: an 8-year prospective study. Arch Phys Med Rehabil. 2009;90(10):1708-1715.
,
Risk of mortality after spinal cord injury: an 8-year prospective study
,
Arch Phys Med Rehabil.
, vol.
90
(pg.
1708
-
1715
)
National Death Index. Available at: http://www.cdc.gov.nchs/ndi.htm. Accessed September 28, 2007. http://www.cdc.gov.nchs/ndi.htm
Krause JS. Factors associated with risk for subsequent injuries after the onset of traumatic spinal cord injury. Arch Phys Med Rehabil. 2004;85:1503-1508.
,
Factors associated with risk for subsequent injuries after the onset of traumatic spinal cord injury
,
Arch Phys Med Rehabil.
, vol.
85
(pg.
1503
-
1508
)
Whiteneck GG, Charlifue SW, Gerhart KA, Overholser JD, Richardson GN. The Craig Handicap Assessment and Reporting Technique. Englewood, CO: Craig Hospital;1992.
,
The Craig Handicap Assessment and Reporting Technique
Strauss D, Shavelle R, DeVivo MJ, Day S. An analytic method for longitudinal mortality studies. J Insurance Med. 2000;32:217-225.
,
An analytic method for longitudinal mortality studies
,
J Insurance Med.
, vol.
32
(pg.
217
-
225
)
DeVivo MJ. Estimating life expectancy for use in determining lifetime costs of care. Top Spinal Cord Inj Rehabil. 2002;7(4):49-58.
,
Estimating life expectancy for use in determining lifetime costs of care
,
Top Spinal Cord Inj Rehabil.
, vol.
7
(pg.
49
-
58
)
Hosmer DW, Lemeshow S. Applied Logistic Regression. 2nd ed. New York: John Wiley and Sons; 2000.
,
Applied Logistic Regression
Alston RJ. Sensation seeking as a psychological trait of drug abuse among persons with spinal cord injury. Rehabil Counsel Bull. 1994;389:154-163.
,
Sensation seeking as a psychological trait of drug abuse among persons with spinal cord injury
,
Rehabil Counsel Bull
, vol.
389
(pg.
154
-
163
)
Hawkins DA, Heinemann A. Substance abuse and medical complications following spinal cord injury. Rehabil Psychol. 1998;43:219-231.
,
Substance abuse and medical complications following spinal cord injury
,
Rehabil Psychol.
, vol.
43
(pg.
219
-
231
)
This content is only available as a PDF.