Survival rates for individuals with SCI have made steady improvements over the past five decades. Prior to World War II life expectancy for individuals with SCI was quite poor (Geisler et al. 1983). Leading causes of death were those resulting from renal failure and infection (Lammertse 2001). Since the introduction of antibiotics, improved emergency transportation, advances in long-term health interventions, and the availability of preventative care at specialized treatment centres, mortality rates have been steadily decreasing and the causes of death have begun to mirror those of the general population (Whiteneck et al. 1992; DeVivo et al. 1999). However, life expectancy is still diminished compared to the general population (Whiteneck et al. 1992; Hartkopp et al. 1997; McColl et al. 1997; Frankel et al. 1998; DeVivo et al. 1999; Yeo et al. 2000; Krause et al. 2004).
Causes of death among individuals with SCI and those in the general population appear to be similar. In 2011, the two leading causes of death in high- and middle-income countries for the general population were ischemic heart disease and stroke (WHO 2011). Other common causes were tracheal bronchus and lung cancers, chronic obstructive pulmonary disease, lower respiratory infections, and Alzheimer’s disease and other dementias (WHO 2011). Similarly, two leading causes of death in the SCI population are respiratory complications and heart disease (Hartkopp et al.1997; Frankel et al.1998; DeVivo et al. 1999; Soden et al. 2000; Zeilig et al. 2000; Garshick et al. 2005). Additionally, the latest report from the National Spinal Cord Injury Database (NSCIDB) indicates the main causes of death in persons with SCI in the United States are pneumonia and septicemia (NSCISC 2013). The high rates of cardiovascular disease in the SCI population may be partly due to physiological and functional changes following injury (Dearwater et al. 1986; Yekutiel et al. 1989; Bauman et al. 1992a, b; Gupta 2006). Interestingly, cancer is a growing cause of death in persons with SCI (DeVivo et al. 1999; Zeilig et al. 2000; Imai et al. 2004).
In general, it appears that as individuals with SCI age, cause of death becomes similar to age matched controls (Capoor & Stein 2005). Some deaths, however, may occur prematurely (e.g., from cardiovascular disease; Yekutiel et al. 1995), and there are some notable differences in mortality patterns between the SCI and the general populations.
In this section, 5 longitudinal studies and 1 cross-sectional study on mortality and life expectancy among individuals with spinal cord injury are reviewed.