International comparison: Spinal cord injury in the USA and UK

NeuroRehabilitation. 2023;53(4):595-598. doi: 10.3233/NRE-230153.

Abstract

Background: Long-term survival after spinal cord injury (SCI) has been extensively studied in the US and UK.

Objective: To compare SCI epidemiology and survival results between the US and UK for the same time period and patient groups.

Methods: We restricted attention to persons injured at ages 18 and older who had survived at least 2 years post injury and were not ventilator dependent. We performed survival analysis using logistic regression on person-year data with time-dependent covariates. The resulting mortality rates were used to construct life tables in order to obtain life expectancies.

Results: The average age at injury, percentage male, and level/grade of injury were rather similar between the two countries. After adjustment for risk factors, UK mortality was 85% of that in the US (95% c.i. 80% to 91%, p < 0.0001). Mortality increased by 0.3% per year over the 1980 to 2012 study period (HR = 1.003); this was not statistically significant (p = 0.44). The US and UK life expectancies are nearly the same percentage of their respective general population values, differing by at most 2%.

Conclusion: Long-term mortality after SCI in the UK is roughly 15% lower than that in the US. The general population mortality in the UK is also approximately 15% lower, however, and thus the percentages of normal life expectancy in the two countries prove to be strikingly similar.

Keywords: Military; TBI; brain injury; head injury; improvement; interdisciplinary; outcomes; physical therapy; psychotherapy; rehabilitation; satisfaction; speech therapy; telehealth.

MeSH terms

  • Humans
  • Life Expectancy
  • Logistic Models
  • Male
  • Risk Factors
  • Spinal Cord Injuries* / epidemiology
  • United Kingdom / epidemiology
  • United States / epidemiology