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Acute respiratory tract infection visits of veterans with spinal cord injuries and disorders: rates, trends, and risk factors.
Smith BM, Evans CT, Kurichi JE, Weaver FM, Patel N, Burns SP. Acute respiratory tract infection visits of veterans with spinal cord injuries and disorders: rates, trends, and risk factors. The journal of spinal cord medicine. 2007 Jan 1; 30(4):355-61.
BACKGROUND/OBJECTIVES: Respiratory complications are a major cause of illness and death in persons with spinal cord injuries and dysfunction (SCIandDs). 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 (PandI), lower respiratory tract infections (LRIs), and upper respiratory tract infections (URIs), in veterans with SCIandDs 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 SCIandDs. To examine the associations between time, patient characteristics, and annual number of ARI visits, we used random effect negative binomial models. RESULTS: Veterans with SCIandDs 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 SCIandD veterans per year. Older veterans were more likely than younger to have PandI visits and less likely to have URI visits (P < 0.01). Veterans with paraplegia had fewer PandI visits than subjects with tetraplegia (IRR = 0.58; Cl = 0.51-0.67). CONCLUSIONS: Visit rates for ARIs are stable for veterans with SCIandDs. 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 SCIandDs.