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Average of seven year survival on respirator?

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    Average of seven year survival on respirator?

    Bubo wrote:
    Quote from Dr. Young:
    " All that I can remember was what Dr. Onders said that people on respirators live an average of seven years and that Christopher had lived nine years."

    Would you comment that Dr. Young, for people here who are on respirators?

    Thank you very much for your question. I have been trying to find out where Dr. Onders got the statistic that people with spinal cord injury and on respirators survive an average of seven years. I really don't know where this statistic comes from and wonder whether it is valid. Everything depends of course on the care of the person and the risk factors of the person. I know that in many countries, there are very few people with high cervical spinal cord injury. For example, in China, when I go through the hospitals and wards, I seldom see a person who is on a respirator.

    What Dr. Onders does is very important, i.e. getting people off the respirator. There is no question that people on respirators have a high risk of pneumonia and pneumonia has become the most common cause of death in people with cervical spinal cord injuries.

    • In 1995, DiVivo and Ivie did an analysis of 435 people admitted to SCI Model Systems Centers between 1973 to 1992 who survived at least 24 hours after injury and who was ventilator dependent or who died before discharge while still on a respirator. The overall 1-year survival was 25.4% while the 15-year survival rate was 16.8%. Among those who survived the first year, cumulative survival over the next 14 years was 61.4%.

    Wicks & Menter (1986) pointed out that 76 of 134 patients who were initially on ventilator were successfully weaned. Of those who left the hospital, survival rate was 90% at one year, 56% in 3 years, and 33% at five years. So, in 1986, the survival rate was not good.

    • If one goes to the UAB Facts and Figures site, the average life expectancy of a person who survived one year after injury is 38.5 years if one were 20 years old and a high tetraplegic. A ventilator dependent 40-year old high tetraplegic has an average life expectancy of 11.4 years, compared to 25 years for a low tetraplegic (C5-C8), 28.7 years for a paraplegic, and 39.2 years for a person without SCI. Christopher was 42 years old when he was injured. The statistics do suggest that a respirator-bound high tetraplegic who is 60 years at the time of injury have an average life expectancy of 3.1 years. There is no question that being on an older person on respirator significantly lowers one's life expectancy.

    It is possible that Dr. Onders was referring to the average survival of a tetraplegic who is 52 years old and on a respirator. But, no matter what the average survivals were, Christopher's death came as a real shock to me and, I think, to many others. My office had many phone calls from families who were worried about that statistic.

    Pneumonia is the main risk for people on respirators. On the other hand, I don't know or think that pneumonia was the reason why Christopher Reeve died. He was having health problems all summer long from repeated infections. It is not clear why he was having these infections and where it was coming from.

    I was on several other shows after the Today Show with Dr. Onders and he did qualify his original statements significantly. I think that he did so even in the Today Show when he pointed out that things are changing.

    What the discussion did for me, however, was to push home the point that we need a cure quickly.


    PS I made a mistake in an earlier version and said 40-year old rather than 20-year old in the statistics paragraph.

    [This message was edited by Wise Young on 10-14-04 at 10:40 AM.]

    Dear Wise,
    Thanks for the answer.
    Of those you met and on ventilator, what was the longest time the subject was on it when you met him/her?



      I personally know several tetraplegics who have been on a ventilator for over 20 years. I once met a man in an iron lung (from polio) who had been in the iron lung for 40 years. Going back much further than that, however, is tricky because the ventilators were not very good before the 1960's. It is hard for us to imagine how much the technology has improved in the past ten years. I believe that with proper care, most people on ventilators can survive many decades on a ventilator. In Hong Kong recently, I met a woman who was a high tetraplegic and had diaphragm stimulators placed in 1991. She is the most amazing person that I have ever met. She did not look like she was all that paralyzed and had quite a strong voice. Her name is Christine and she gave a wonderful speech at the press conference that we had announcing the China SCI Network.