{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T03:12:12Z","timestamp":1790824332316,"version":"4.1.0"},"reference-count":32,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2021,12,22]],"date-time":"2021-12-22T00:00:00Z","timestamp":1640131200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>To study the mortality, cause and risk indicators of death in German patients with traumatic spinal cord injury, patients with traumatic spinal cord injury admitted to Berufsgenossenschaftliches Trauma Hospital Hamburg between 1 January 1997 and 31 December 2018, aged between 16 and 60 with a minimal survival of one year after injury, were included. Further criteria were the absence of life-limiting comorbidities at the time of injury. 223 deceased patients with traumatic spinal cord injury were identified, investigated on and partly compared to the surviving subjects. We aimed to discover specific complications that were related to Spinal Cord Injury and responsible for a possibly limited life expectancy. Data collection was performed during in- and outpatient treatment. A statistical analysis was performed to compare groups. The post-injury life expectancy was 25.0 years with a significant correlation regarding the level of lesion and severity of injury. The leading causes of death were cardiovascular diseases and pneumonia. Bladder cancer was the most common fatal malignant tumor. The life expectancy of patients suffering from traumatic spinal cord injury is limited. The longer a patient survives after injury and the lower the level of lesion, the more likely an age-related cause of death becomes. Bladder cancer is significantly more frequent when compared to the overall distribution of tumor diseases in Germany.<\/jats:p>","DOI":"10.3390\/jcm11010026","type":"journal-article","created":{"date-parts":[[2021,12,22]],"date-time":"2021-12-22T10:24:52Z","timestamp":1640168692000},"page":"26","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Long-Term Survival and Causes of Death in Patients below the Age of 60 with Traumatic Spinal Cord Injury in Germany"],"prefix":"10.3390","volume":"11","author":[{"given":"Roland","family":"Thietje","sequence":"first","affiliation":[{"name":"Center for Spinal Injuries, BG Klinikum Hamburg, 21033 Hamburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Birgitt","family":"Kowald","sequence":"additional","affiliation":[{"name":"Center for Spinal Injuries, BG Klinikum Hamburg, 21033 Hamburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3037-8066","authenticated-orcid":false,"given":"Ralf","family":"B\u00f6thig","sequence":"additional","affiliation":[{"name":"Center for Spinal Injuries, BG Klinikum Hamburg, 21033 Hamburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4927-549X","authenticated-orcid":false,"given":"Arndt P.","family":"Schulz","sequence":"additional","affiliation":[{"name":"Center for Spinal Injuries, BG Klinikum Hamburg, 21033 Hamburg, Germany"},{"name":"Department of Biomechanics and orthopedic Research, University L\u00fcbeck, 23538 Luebeck, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Markus","family":"Northmann","sequence":"additional","affiliation":[{"name":"Center for Spinal Injuries, BG Klinikum Hamburg, 21033 Hamburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8845-276X","authenticated-orcid":false,"given":"Yannick","family":"Rau","sequence":"additional","affiliation":[{"name":"Medical Faculty, University of L\u00fcbeck, 23538 L\u00fcbeck, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sven","family":"Hirschfeld","sequence":"additional","affiliation":[{"name":"Center for Spinal Injuries, BG Klinikum Hamburg, 21033 Hamburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,12,22]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1055\/s-0042-112079","article-title":"Epidemiologie, \u00c4tiologie und Mortalit\u00e4t bei Querschnittl\u00e4hmung","volume":"8","author":"Thietje","year":"2016","journal-title":"Neuroreha"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"651","DOI":"10.1038\/sc.2017.23","article-title":"Long-term survival after traumatic spinal cord injury: A 70-year British study","volume":"55","author":"Savic","year":"2017","journal-title":"Spinal Cord"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"2827","DOI":"10.1007\/s00345-020-03077-3","article-title":"Traumatic spinal cord injury confers bladder cancer risk to patients managed without permanent urinary catheterization: Lessons from a comparison of clinical data with the national database","volume":"38","author":"Tiburtius","year":"2020","journal-title":"World J. Urol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"182","DOI":"10.1159\/000382079","article-title":"Mortality and longevity after a spinal cord injury: Systematic review and meta-analysis","volume":"44","author":"Chamberlain","year":"2015","journal-title":"Neuroepidemiology"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"76","DOI":"10.1038\/sj.sc.3100351","article-title":"Survival and cause of death after traumatic spinal cord injury. A long-term epidemiological survey from Denmark","volume":"35","author":"Hartkopp","year":"1997","journal-title":"Spinal Cord"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1356","DOI":"10.1016\/S0003-9993(98)90227-1","article-title":"Suicide in a spinal cord injured population: Its relation to functional status","volume":"79","author":"Hartkopp","year":"1998","journal-title":"Arch. Phys. Med. Rehabil."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"604","DOI":"10.1038\/sj.sc.3101080","article-title":"Causes of death after spinal cord injury","volume":"38","author":"Soden","year":"2020","journal-title":"Spinal Cord"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"145","DOI":"10.2340\/16501977-0017","article-title":"Mortality after spinal cord injury in Norway","volume":"39","author":"Lidal","year":"2007","journal-title":"J. Rehabil. Med."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1027\/0227-5910.30.1.34","article-title":"Suicidal ideation and behavior and some psychological correlates in physically disabled motor-vehicle accident survivors","volume":"30","author":"Marusic","year":"2009","journal-title":"Crisis"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1517","DOI":"10.1089\/neu.2009.1138","article-title":"Survival after spinal cord injury: A systematic review","volume":"27","author":"Castellote","year":"2010","journal-title":"J. Neurotrauma."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1080\/10790268.2010.11689686","article-title":"Late mortality during the first year after acute traumatic spinal cord injury: A prospective, population-based study","volume":"33","author":"Divanoglou","year":"2010","journal-title":"J. Spinal. Cord Med."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1038\/s41394-020-0307-4","article-title":"Incidental bladder cancer at initial urological workup of spinal cord injury patients","volume":"6","author":"Golka","year":"2020","journal-title":"Spinal Cord Ser. Cases"},{"key":"ref_13","first-page":"700","article-title":"Urinary bladder cancer as a late sequela of spinal cord injury: Decision-making aids for assessment of this causal association","volume":"59","author":"Zellner","year":"2020","journal-title":"Urol. A"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"814","DOI":"10.1038\/s41393-020-00593-2","article-title":"Causes of death after spinal cord injury in the Czech Republic","volume":"59","author":"Kriz","year":"2021","journal-title":"Spinal Cord"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"e103203","DOI":"10.5812\/hmj.103203","article-title":"Epidemiological Study of Traumatic Spinal Injuries in Iranian Patients from 2007 to 2017","volume":"25","author":"Saatian","year":"2021","journal-title":"Hormozgan Med. J."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"891","DOI":"10.1038\/sc.2017.64","article-title":"Causes of death after traumatic spinal cord injury-a 70-year British study","volume":"55","author":"Savic","year":"2017","journal-title":"Spinal Cord"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1499","DOI":"10.1007\/s11999-016-5133-4","article-title":"Classifications In Brief. American Spinal Injury Association (ASIA) Impairment Scale","volume":"475","author":"Roberts","year":"2017","journal-title":"Clin. Orthop. Relat. Res."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1556","DOI":"10.1016\/j.apmr.2020.05.016","article-title":"A Comparison of Diagnostic Stability of the ASIA Impairment Scale Versus Frankel Classification Systems for Traumatic Spinal Cord Injury","volume":"101","author":"Kirshblum","year":"2020","journal-title":"Arch. Phys. Med. Rehabil."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1097\/BCR.0b013e3182a3aaaa","article-title":"Process evaluation of software using the International classification of external causes of injuries for collecting burn injury data at burn centers in the United States","volume":"35","author":"Villaveces","year":"2014","journal-title":"J. Burn Care Res."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"596","DOI":"10.1038\/sc.2010.172","article-title":"International Spinal Cord Injury Data Set. Standardization of data analysis and reporting of results from the International Spinal Cord Injury Core Data Set","volume":"49","author":"DeVivo","year":"2011","journal-title":"Spinal Cord"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"535","DOI":"10.1038\/sj.sc.3101958","article-title":"International Spinal Cord Injury Core Data Set","volume":"44","author":"DeVivo","year":"2006","journal-title":"Spinal Cord"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"679","DOI":"10.1038\/sc.2011.12","article-title":"ISCoS-WHO collaboration. International Perspectives of Spinal Cord Injury (IPSCI) report","volume":"49","author":"Bickenbach","year":"2011","journal-title":"Spinal Cord"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1038\/sj.sc.3101616","article-title":"Prevalence of spinal cord injury in Helsinki","volume":"43","author":"Dahlberg","year":"2005","journal-title":"Spinal Cord"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"313","DOI":"10.1038\/sc.2009.133","article-title":"A 50-year follow-up of the incidence of traumatic spinal cord injuries in Western Norway","volume":"48","author":"Hagen","year":"2010","journal-title":"Spinal Cord"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"219","DOI":"10.1159\/000336014","article-title":"Incidence and prevalence of spinal cord injury in Canada: A national perspective","volume":"38","author":"Noonan","year":"2012","journal-title":"Neuroepidemiology"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"882","DOI":"10.1038\/sc.2012.65","article-title":"Traumatic spinal cord injury in Saudi Arabia: An epidemiological estimate from Riyadh","volume":"50","author":"Alshahri","year":"2012","journal-title":"Spinal Cord"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"481","DOI":"10.2340\/16501977-0812","article-title":"Survival after spinal cord injury in Finland","volume":"43","author":"Ahoniemi","year":"2011","journal-title":"J. Rehabil. Med."},{"key":"ref_28","first-page":"37","article-title":"Survival after spinal cord injury in Australia","volume":"86","year":"2005","journal-title":"Arch. Phys. Med. Rehabil."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"408","DOI":"10.1038\/sj.sc.3101729","article-title":"A prospective assessment of mortality in chronic spinal cord injury","volume":"43","author":"Garshick","year":"2005","journal-title":"Spinal Cord"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"803","DOI":"10.1038\/sc.2012.55","article-title":"Life expectancy after spinal cord injury: A 50-year study","volume":"50","author":"Middleton","year":"2012","journal-title":"Spinal Cord"},{"key":"ref_31","unstructured":"National Spinal Cord Injury Statistical Center (2021, October 25). Facts and Figures at a Glance 2016. University of Alabama at Birmingham Webpage. Available online: https:\/\/www.nscisc.uab.edu\/public_pages\/FactsFigures_archive."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"784","DOI":"10.1038\/sc.2013.77","article-title":"Predictors of mortality in veterans with traumatic spinal cord injury","volume":"51","author":"Rabadi","year":"2013","journal-title":"Spinal Cord"}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/11\/1\/26\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T07:51:03Z","timestamp":1760169063000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/11\/1\/26"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,12,22]]},"references-count":32,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2022,1]]}},"alternative-id":["jcm11010026"],"URL":"https:\/\/doi.org\/10.3390\/jcm11010026","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,12,22]]}}}