Suicide mortality after spinal cord injury in the United States: injury cohorts analysis

Abstract

Objectives: To compare 12-year suicide-specific mortalities of 3 different injury cohorts, identify the risk factors for suicide mortality after spinal cord injury (SCI), and investigate whether suicide mortality is higher among those with SCI than in the general population.

Design: Retrospective cohort study.

Setting: United States hospitals (n=28) designated as SCI Model Systems.

Participants: Participants (N=31,339) injured between January 1, 1973, and December 31, 1999.

Interventions: Not applicable.

Main outcome measure: Suicide death after SCI.

Results: The crude annual suicide mortality rate during the first 12 years after SCI was 91 per 100,000 person-years for 1973 to 1979 injury cohort, 69 per 100,000 person-years for 1980 to 1989 injury cohort, and 46 per 100,000 person-years for 1990 to 1999 injury cohort. Suicide mortality was associated with race, injury severity, and years since injury. The standardized mortality ratios for the 3 cohorts were 5.2, 3.7, and 3.0, respectively.

Conclusions: Suicide mortality among those with SCI decreased over 3 injury cohorts, but it still remained 3 times higher than that of the general population.

Keywords: AIS; American Spinal Injury Association Impairment Scale; Mortality; NSCISC; National Spinal Cord Injury Statistical Center; Rehabilitation; SCI; SCIMS; SMR; Spinal Cord Injury Model Systems; Spinal cord injuries; Suicide; U.S.; United States; spinal cord injury; standardized mortality ratio.