Introduction: Study drop-out and attrition from treating clinics is common among persons with chronic health conditions. However, if attrition is associated with adverse health outcomes, it may bias or mislead inferences for health policy and resource allocation.
Methods: This retrospective cohort study uses data attained through the Swiss Spinal Cord Injury (SwiSCI) cohort study on persons with spinal cord injury (SCI). Vital status (VS) was ascertained either through clinic medical records (MRs) or through municipalities in a secondary tracing effort. Flexible parametric survival models were used to investigate risk factors for going lost to clinic (LTC) and the association of LTC with subsequent risk of mortality.
Results: 1924 individuals were included in the tracing study; for 1608 of these cases, contemporary VS was initially checked in the MRs. VS was ascertained for 704 cases of the 1608 cases initially checked in MRs; of the remaining cases (n=904), nearly 90% were identified in municipalities (n=804). LTC was associated with a nearly fourfold higher risk of mortality (HR=3.62; 95% CI 2.18 to 6.02) among persons with traumatic SCI. Extended driving time (ie, less than 30 min compared with 30 min and longer to reach the nearest specialised rehabilitation facility) was associated with an increased risk of mortality (HR=1.51, 95% CI 1.02 to 2.22) for individuals with non-traumatic SCI.
Conclusion: The differential risk of LTC according to sociodemographic and SCI lesion characteristics underscores the importance of accounting for attrition in cohort studies on chronic disease populations requiring long-term care. In addition, given the associated risk of mortality, LTC is an issue of concern to clinicians and policy makers aiming to optimise the long-term survival of community-dwelling individuals with traumatic SCI. Future studies are necessary to verify whether it is possible to improve survival prospects of individuals LTC through more persistent outreach and targeted care.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7351285 | PMC |
| http://dx.doi.org/10.1136/bmjopen-2019-035752 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Delayed Neurological Deficits Following Lumbar 1 Burst Fracture: A Diagnostic Challenge Without Radiological Correlates.
Cureus
December 2024
Department of Orthopedics, Spine Unit, Hospital Sungai Buloh, Sungai Buloh, MYS.
Spinal cord injuries, including rare cases without radiological abnormalities, pose diagnostic challenges, particularly in cases of delayed neurological deficit development. This case report describes a 55-year-old man with a stable L1 burst fracture who developed delayed neurological deficits two weeks after sustaining a fall despite no evidence of intrinsic or extrinsic spinal cord abnormalities on magnetic resonance imaging (MRI). The patient initially presented with back pain, normal muscle strength across all myotomes, and imaging that showed no canal stenosis or retropulsion fragments.
View Article and Find Full Text PDF3D bioprinted dynamic bioactive living construct enhances mechanotransduction-assisted rapid neural network self-organization for spinal cord injury repair.
Bioact Mater
April 2025
State Key Laboratory of New Ceramics and Fine Processing, Key Laboratory of Advanced Materials, School of Materials Science and Engineering, Tsinghua University, Beijing, 100084, China.
Biomimetic neural substitutes, constructed through the bottom-up assembly of cell-matrix modulus via 3D bioprinting, hold great promise for neural regeneration. However, achieving precise control over the fate of neural stem cells (NSCs) to ensure biological functionality remains challenging. Cell behaviors are closely linked to cellular dynamics and cell-matrix mechanotransduction within a 3D microenvironment.
View Article and Find Full Text PDFAtlantoaxial Subluxation Related to Axial Spondylarthritis: A Case-Based Systematic Review.
Mediterr J Rheumatol
December 2024
Department of Rheumatology.
Aim: Atlantoaxial dislocation is a loss of stability between the atlas and axis. It is rarely reported in patients with axial spondylarthritis. We present an axial spondylarthritis case revealed by atlantoaxial subluxation.
View Article and Find Full Text PDFComplex staged hybrid repair of extent II thoracoabdominal aortic aneurysm secondary to type A aortic dissection.
J Vasc Surg Cases Innov Tech
April 2025
Division of Vascular Surgery, London Health Sciences Center, University of Western Ontario, London, Ontario, Canada.
Despite advancements in surgical techniques and critical care, managing complications of type A and B aortic dissections remains challenging. Common morbidities include paraplegia, renal failure, stroke, and intestinal ischemia. Risks are especially high in extensive repairs, such as Crawford extent II thoracoabdominal aortic aneurysms, and in older patients or those with heart failure, poor pulmonary function, or renal disease.
View Article and Find Full Text PDFIntrathecal transplantation of human umbilical cord mesenchymal stem cells enhances spinal cord injury recovery: Role of miR‑124‑3p as a biomarker.
Exp Ther Med
March 2025
Department of Neurosurgery, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang Uygur Autonomous Region 830000, P.R. China.
Spinal cord injury (SCI) is a severe condition that often leads to permanent functional impairments. The current treatment options are limited and there is a need for more effective treatments. Human umbilical cord mesenchymal stem cells (hUCMSCs) have shown promise in promoting neuroregeneration and modulating immune response.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!