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Differences in mortality patterns and life expectancy between spinal cord injured persons and the general population in Switzerland since 1990

English title Differences in mortality patterns and life expectancy between spinal cord injured persons and the general population in Switzerland since 1990
Applicant Brinkhof Martin
Number 166603
Funding scheme Project funding (special)
Research institution Schweizer Paraplegiker-Forschung AG
Institution of higher education Swiss Paraplegic Research - SPF
Main discipline Public Health and Health Services
Start/End 01.04.2017 - 30.09.2019
Approved amount 230'441.00
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All Disciplines (2)

Discipline
Public Health and Health Services
Accidents

Keywords (6)

large nested project (SNC); spinal cord injury; cohort study; epidemiology; Switzerland; mortality

Lay Summary (German)

Lead
Daten aus anderen Ländern zeigen, dass Menschen mit Querschnittlähmung eine niedrigere Lebenserwartung als die Allgemeinbevölkerung haben. Diese SNF-geförderte Studie untersucht, ob und in welchem Ausmass diese Aussage für die Schweiz zutrifft. Damit leistet sie einen wichtigen Beitrag zur Schweizer Datenlage bezüglich Querschnittslähmung und für die Begründung allfälliger gesundheitspolitischer Massnahmen.
Lay summary

Inhalte und Ziele des Forschungsprojekts

Eine traumatische Querschnittlähmung wird durch eine mechanische Einwirkung von aussen, zum Beispiel durch einen Unfall, hervorgerufen. Eine Querschnittlähmung ist nicht heilbar und führt abhängig vom Schweregrad zu einem lebenslangen Verlust von Körperfunktionen, einer erhöhten Krankheitslast, Verlust von Funktionsfähigkeit, Behinderung sowie sozioökonomischer Benachteiligung. Dementsprechend zeigen Daten aus diversen Ländern, dass die Lebenserwartung von Betroffenen verkürzt ist. Für die Schweiz liegen Angaben zur Lebenserwartung jedoch nicht vor, was einer gezielten, evidenzbasierten Gesundheitspolitik bezüglich Querschnittlähmung im Wege steht.

In diesem SNF-geförderten Projekt werden die allgemeine und die todesursachen-spezifische Sterblichkeitsrate von Menschen mit einer traumatischen Querschnittslähmung untersucht und mit der Allgemeinbevölkerung verglichen. Die Datengrundlage bildet die Schweizer Kohortenstudie für Menschen mit einer Rückenmarksverletzung SwiSCI (Swiss Spinal Cord Injury Cohort Study). Kollaborationspartner ist die Schweizer Nationalkohorte SNC (Swiss National Cohort). Die Verknüpfung zwischen SwiSCI und SNC Daten ermöglicht die Zusammenführung von soziodemographischen und sozioökonomischen Informationen und Todesursachen. So können dann beispielsweise Zusammenhänge zwischen der sozioökonomischen Situation (z.B. Bildung, Einkommen) von Betroffenen und deren Lebenserwartung untersucht werden.

Wissenschaftlicher und gesellschaftlicher Kontext des Forschungsprojekts

Das Projekt führt Daten von zwei umfassenden nationalen Kohortenstudien zusammen und wertet sie integral aus. Ein Vergleich  der Lebenserwartung trägt dazu bei, Ursachen für die kürzere Lebenserwartung von querschnittgelähmten Menschen zu identifizieren und Prioritäten für Massnahmen gegen vermeidbare Todesursachen zu setzen.

 

Direct link to Lay Summary Last update: 23.02.2017

Responsible applicant and co-applicants

Employees

Publications

Publication
Comparison of All-Cause and Cause-Specific Mortality of Persons with Traumatic Spinal Cord Injuries to the General Swiss Population: Results from a National Cohort Study
Chamberlain Jonviea D., Buzzell Anne, Gmünder Hans Peter, Hug Kerstin, Jordan Xavier, Moser André, Schubert Martin, Zwahlen Marcel, Brinkhof Martin W.G. (2019), Comparison of All-Cause and Cause-Specific Mortality of Persons with Traumatic Spinal Cord Injuries to the General Swiss Population: Results from a National Cohort Study, in Neuroepidemiology, 52(3-4), 205-213.
Comparison of All-Cause and Cause-Specific Mortality of Persons with Traumatic Spinal Cord Injuries to the General Swiss Population: Results from a National Cohort Study
Chamberlain Jonviea D., Buzzell Anne, Gmünder Hans Peter, Hug Kerstin, Jordan Xavier, Moser André, Schubert Martin, Zwahlen Marcel, Brinkhof Martin W.G. (2019), Comparison of All-Cause and Cause-Specific Mortality of Persons with Traumatic Spinal Cord Injuries to the General Swiss Population: Results from a National Cohort Study, in Neuroepidemiology, 52(3-4), 205-213.
All-cause and cause-specific mortality following non-traumatic spinal cord injury: evidence from a population-based cohort study in Switzerland
Buzzell A., Chamberlain J. D., Eriks-Hoogland I., Hug K., Jordan X., Schubert M., Zwahlen M., Brinkhof M. W. G. (2019), All-cause and cause-specific mortality following non-traumatic spinal cord injury: evidence from a population-based cohort study in Switzerland, in Spinal Cord.

Collaboration

Group / person Country
Types of collaboration
Institute of Health and Biomedical Innovation Australia (Oceania)
- in-depth/constructive exchanges on approaches, methods or results
- Publication

Scientific events

Active participation

Title Type of contribution Title of article or contribution Date Place Persons involved
Annual Scientific meeting of International Spinal Cord Society (ISCoS) Talk given at a conference All-cause and cause-specific mortality following non-traumatic spinal cord injury: evidence from a population-based rehabilitation cohort in Switzerland 05.11.2019 Nice, France Zwahlen Marcel; Brinkhof Martin; Chamberlain Jonviea;
Society for Longitudinal and Life Course Studies conference Talk given at a conference Mortality differentials between traumatic and non-traumatic spinal cord injury: a causal inference approach 25.09.2019 Potsdam, Germany Zwahlen Marcel; Brinkhof Martin; Chamberlain Jonviea;
Society for Longitudinal and Life Course Studies conference Talk given at a conference All-cause and cause-specific mortality following non-traumatic spinal cord injury: evidence from a population-based rehabilitation cohort in Switzerland 25.09.2019 Potsdam, Germany Zwahlen Marcel; Chamberlain Jonviea; Brinkhof Martin;
Swiss Public Health Conference Poster Mortality differentials between traumatic and non-traumatic spinal cord injury: a causal inference approach 28.08.2019 Winterthur, Switzerland Zwahlen Marcel; Chamberlain Jonviea; Brinkhof Martin;
Annual Scientific meeting of International Spinal Cord Society (ISCoS) Talk given at a conference Mortality differentials between traumatic and non-traumatic spinal cord injury: a causal inference approach 13.09.2018 Sydney, Australia Brinkhof Martin; Chamberlain Jonviea; Zwahlen Marcel;
Society for Longitudinal and Life Course Studies Conference Poster Mortality and longevity after traumatic spinal cord injury in Switzerland from 1990-2011: A 21-year longitudinal study 09.07.2018 Milan, Italy Zwahlen Marcel; Chamberlain Jonviea; Brinkhof Martin;


Associated projects

Number Title Start Funding scheme
153256 The social production of wellbeing in disability: a longitudinal study of persons with spinal cord injury and their caregivers 01.02.2015 Project funding (Div. I-III)

Abstract

Traumatic spinal cord injuries (TSCIs) are life altering events which can lead to life-long loss of function, reduced quality of life, increased risk of morbidity, and enhanced mortality. Since 2011 four major centers specialized in SCI rehabilitation in Switzerland (Spinal Cord Injury Center of the Balgrist University Hospital, Zürich; Centre for Spinal Cord Injury and Severe Head Injury, REHAB Basel; Clinique Romande de Réadaptation, Sion; and the Swiss Paraplegic Centre, Nottwil) established a rehabilitation-based cohort of persons with spinal cord injury (SCI), the Swiss Spinal Cord Injury (SwiSCI) cohort study. The SwiSCI cohort is funded by Swiss Paraplegic Foundation. The SwiSCI Study is one of the largest investigation of persons with SCI in Europe. In addition to prospective data collection on SCI patients, SwiSCI also implemented retrospective data collection on SCI patients who had their injuries previously to 2012. More than two thousand SCI patients (2’120) injured in the years 1990-2012 have been included to date. The aim of this SNF project is to examine all-cause and cause-specific mortality in the TSCI population and to compare their mortality patterns and life expectancy to the general population for the years since 1990. As mortality ascertainment in the retrospective SwiSCI cohort (N = 2’120) is possibly incomplete (318 deaths have already be recorded), we plan to complement and complete ascertainment of mortality through anonymous linkage of the SwiSCI cohort with the Swiss National Cohort (SNC). The linkage would particularly allow for ascertainment of causes of death in persons with TSCI. The SNC is a large, country-wide study of mortality in Switzerland. Anonymous probabilistic linkage between the SwiSCI cohort and the SNC will be obtained through use of specific demographic and residential information. In addition, linkage to the SNC will allow to assess mortality differentials in the SwiSCI cohort by education and socio-economic position. We will calculate standardized mortality ratios (SMRs) to compare the SwiSCI cohort with the Swiss resident general population. Although the SwiSCI cohort is fixed and cannot be increased, this study will be able to detect meaningful differences in mortality between persons living with TSCI and the general population (in terms of the width of 95% confidence intervals of the SMRs). This joint project between SwiSCI and the SNC will provide unique comparative analyses mortality outcomes. We expect to show that discrepancies with the general population exist which, in turn, will certainly inform health care policy for a major disability group in Switzerland.
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