TY - JOUR
T1 - Psychologic Factors and Risk of Mortality After Spinal Cord Injury
AU - Krause, James S.
AU - Carter, Rickey
AU - Zhai, Yusheng
AU - Reed, Karla
N1 - Funding Information:
Supported by a field initiated grant from the National Institute for Disability and Rehabilitation Research (grant no. H133G030117) and the Model Spinal Cord Injury Systems (grant no. H133N000005) and the National Institutes of Health (1R01 NS 48117-01 A1). The opinions here are those of the grantee and do not necessarily reflect those of the funding agencies.
PY - 2009/4
Y1 - 2009/4
N2 - 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.
AB - 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.
KW - Mortality
KW - Personality
KW - Rehabilitation
KW - Risk
KW - Spinal cord injuries
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U2 - 10.1016/j.apmr.2008.10.014
DO - 10.1016/j.apmr.2008.10.014
M3 - Article
C2 - 19345779
AN - SCOPUS:63349096631
SN - 0003-9993
VL - 90
SP - 628
EP - 633
JO - Archives of Physical Medicine and Rehabilitation
JF - Archives of Physical Medicine and Rehabilitation
IS - 4
ER -