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Acute respiratory tract infection visits of veterans with spinal cord injuries and disorders: rates, trends, and risk factors

BACKGROUND/OBJECTIVES: Respiratory complications are a major cause of illness and death in persons with spinal cord injuries and dysfunction (SCI&Ds). The objectives of this study were to examine rates of outpatient visits over 5 years for acute respiratory tract infections (ARIs), including pneumonia and influenza (P&I), lower respiratory tract infections (LRIs), and upper respiratory tract infections (URIs), in veterans with SCI&Ds and to determine whether individual characteristics were associated with the number of annual visits for each type of ARI. METHODS: This was a longitudinal (fiscal years 1998-2002) study of ARI visits at the Veterans Health Administration (VA) in 18,693 veterans with SCI&Ds. To examine the associations between time, patient characteristics, and annual number of ARI visits, we used random effect negative binomial models. RESULTS: Veterans with SCI&Ds had a total of 11,113 ARI visits over the 5-year period. There was a slightly decreasing trend for LRI visits over time (P < 0.01) but no significant change for other ARIs over time. There were 30 to 35 pneumonia visits and 21 to 30 acute bronchitis visits per 1,000 SCI&D veterans per year. Older veterans were more likely than younger to have P&I visits and less likely to have URI visits (P < 0.01). Veterans with paraplegia had fewer P&I visits than subjects with tetraplegia (IRR = 0.58; Cl = 0.51-0.67). CONCLUSIONS: Visit rates for ARIs are stable for veterans with SCI&Ds. Identifying risk factors associated with ARI visits is an important first step to improve prevention and treatment of ARIs and to improve the health of veterans with SCI&Ds Keywords : Adult,Aged,Ambulatory Care,Bronchitis,complications,epidemiology,Humans,injuries,Longitudinal Studies,Male,methods,Middle Aged,Outcome Assessment (Health Care),Paraplegia,Respiratory Tract Infections,Retrospective Studies,Risk Factors,Spinal Cord,Spinal Cord Injuries,statistics & numerical data,Time,trends,United States,United States Department of Veterans Affairs,Veterans,, Respiratory,Tract,Infection,Visits, lower back pain x ray or mri

Date of Publication : 2007

Authors : Smith BM;Evans CT;Kurichi JE;Weaver FM;Patel N;Burns SP;

Organisation : Department of Veterans Affairs, Spinal Cord Injury Quality Enhancement Research Initiative (SCI QUERI), Edward Hines Jr VA Hospital, Hines, Illinois 60141, USA. Bridget.Smith@va.gov

Journal of Publication : J Spinal Cord Med

Pubmed Link : https://www.ncbi.nlm.nih.gov/pubmed/17853657

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