Michael Devivo - Academia.edu (original) (raw)

Papers by Michael Devivo

The journal of spinal cord medicine, 2018

From: Department of Physical Medicine and Rehabilitation, University of Missouri at Columbia, and... more From: Department of Physical Medicine and Rehabilitation, University of Missouri at Columbia, and Alabama Orthopedic and Spine Center, Birmingham, AL; The Orthopedic Center, Huntsville, AL; Orthopedic and Spine Center at Polaris, Columbus, OH; Neurosurgical Associates, Department of Radiology, University of Alabama at Birmingham, Birmingham, AL. Address Correspondence: Bradly S. Goodman, MD, Alabama Orthopedic and Spine Center, 52 Medical Park East Dr., Suite 115, Birmingham, AL 35235 E-mail: drspudhead@aol.com Disclaimer: There was no external funding in preparation of this manuscript. Confl ict of Interest: None Manuscript received on 5/17/2005 Revision submitted on 6/30/2005 Accepted for publication on 6/30/2005 is avascular throughout life (6-8), while others (9-11) believe that disc injury itself stimulates vascular ingrowth. Yet Kauppilla et al (12) have noted that “...vascular changes occurred before degeneration of the disc at every lumbar level, suggesting that disturbances...

The Journal of Urology, 2021

INTRODUCTION AND OBJECTIVE:To evaluate the impact of bladder management method, specifically chro... more INTRODUCTION AND OBJECTIVE:To evaluate the impact of bladder management method, specifically chronic indwelling catheter (IndC), on overall survival in patients with spinal cord injury (SCI) in Spi...

NeuroRehabilitation (Reading, MA), 2004

Archives of Physical Medicine and Rehabilitation

To quantify the burden of traumatic spinal cord injury (SCI) as defined by nonfatal health loss a... more To quantify the burden of traumatic spinal cord injury (SCI) as defined by nonfatal health loss and premature mortality among a large sample of participants over a 44-year period, and estimate the national burden of SCI in the United States for the year 2010. Longitudinal. National SCI Model Systems and Shriners Hospitals. Individuals (N=51,226) were categorized by neurologic level of injury as cervical (n=28,178) or thoracic and below (n=23,048). The burden of SCI was calculated in years lost due to premature mortality (YLL), years lived with disability (YLD), and disability-adjusted life years (DALY). For those with cervical level injuries, the overall YLLs and YLDs were 253,745 and 445,709, respectively, for an estimated total of 699,454 DALYs. For those with thoracic and below level injuries, the overall YLLs and YLDs were 153,885 and 213,160, respectively, for an estimated total of 367,045 DALYs. Proportionally adjusted DALYs attributable to SCI in 2010 were 445,911. SCIs accounted for over 1 million years of healthy life lost in a national sample over a 44-year span. We estimated that 445,911 DALYs resulted from SCIs in the US in 2010 alone, placing the national burden of SCIs above other impactful conditions such as human immunodeficiency virus/acquired immune deficiency syndrome. Future investigations may employ DALYs to monitor trends in SCI burden in response to innovations in SCI care and identify subgroups of persons with SCIs for whom tailored interventions might improve DALYs.

The journal of spinal cord medicine, Jan 20, 2018

To determine the association between spinal cord injury (SCI) etiology categories and mortality, ... more To determine the association between spinal cord injury (SCI) etiology categories and mortality, and examine the association between etiology sub-categories and mortality. Prospective cohort study. Model Systems and Shriners Hospital SCI units. Data were analyzed from 42,627 cases in the SCI Model System Collaborative Survival Study Database from 1973 to 2017. Those with SCI etiologies categorized as vehicular, violent, sports, falls, pedestrian, and medical were included. Not applicable. Time to mortality after SCI. Relative to the sports related etiology category, those with medical, pedestrian, violence, falls, and vehicular related SCIs had a 2.00 (95% confidence intervals (CIs): 1.79-2.24), 1.57 (CIs: 1.34-1.83), 1.54 (CIs: 1.41-1.68), 1.35 (CIs: 1.25-1.45), and 1.26 (CIs: 1.17-1.35) higher hazard for mortality, respectfully. Persons with SCIs from automobile crashes had a 1.38 (CIs: 1.23-1.56) higher hazard for mortality, whereas those with SCIs from motorcycle crashes had a 1...

Topics in spinal cord injury rehabilitation, 2018

Among people with spinal cord injury (SCI), minorities experience a disproportionately higher bur... more Among people with spinal cord injury (SCI), minorities experience a disproportionately higher burden of diseases. Knowledge of data quality by race/ethnicity will help better design racial health disparity research and understand potential errors/biases. To investigate racial/ethnic differences in response completeness in a longitudinal SCI database. This study included 7,507 participants (5,483 non-Hispanic whites, 1,414 non-Hispanic blacks, and 610 Hispanics) enrolled in the National SCI Database who returned for follow-up between 2001 and 2006 and were aged ≥18 years at follow-up. Missing data were defined as any missing, unknown, or refusal response to interview items. The overall missing rate was 29.7%, 9.5%, 9.7%, 10.7%, 12.0%, and 9.8% for the Craig Handicap Assessment and Reporting Technique-Short Form (CHART) economic self-sufficiency subscale, CAGE questionnaire, drug use, Diener's Satisfaction with Life Scale, Patient Health Questionnaire, and pain severity, respectiv...

Spinal cord, Jul 12, 2018

Retrospective observational. To compare results of several different methods for calculating life... more Retrospective observational. To compare results of several different methods for calculating life expectancy in the same sample of people with spinal cord injury (SCI), and critically assess their advantages and disadvantages. Two spinal centres in Great Britain. Survival status of persons with traumatic SCI injured between 1943 and 2010 with follow-up to 2015 was determined. Standardised mortality ratios (SMRs) were calculated using age at injury and current (attained) age, and compared. Life expectancy was then estimated using the SMR methods and compared with the results of a method based on multivariate logistic regression of a person-year dataset. Life expectancy estimates calculated by applying SMRs based on current age to general population period (current) and cohort (projected) life tables were also compared. The estimated life expectancies were significantly higher when the SMRs were based on age at injury. They were also higher when a general population cohort life table ...

Archives of Physical Medicine and Rehabilitation

The Journal of Spinal Cord Medicine

Archives of physical medicine and rehabilitation, 2016

The Spinal Cord Injury Model Systems (SCIMS) centers have provided continuous, comprehensive mult... more The Spinal Cord Injury Model Systems (SCIMS) centers have provided continuous, comprehensive multidisciplinary care for persons with spinal cord injury (SCI) in the United States since their inception in 1970. In addition, the research conducted and the analysis of data collected at these centers facilitate advances in the care and the overall quality of life for people with SCI. Over the past 45 years, the SCIMS program and National Spinal Cord Injury Database (NSCID) have undergone major revisions, which must be recognized in the planning, conduct, and interpretation of SCIMS research to prevent misinterpretation of findings. Therefore, we provide herein a brief review of the SCIMS program and the associated NSCID throughout its history, emphasizing changes and accomplishments within the past 15 years, to facilitate a better understanding and interpretation of the data presented in SCIMS research publications, including the articles published in this special issue of the Archives.

Archives of physical medicine and rehabilitation, Oct 20, 2016

To investigate the association of multiple sets of risk and protective factors (biographic and in... more To investigate the association of multiple sets of risk and protective factors (biographic and injury, socioeconomic, and health) with cause-specific mortality after spinal cord injury (SCI). Retrospective analysis of a prospectively created cohort SETTING: SCI Model Systems facilities (n=20). 8,157 adults with traumatic SCI who were enrolled in a model systems facility after 1973 and received follow-up evaluation that included all study covariates (between November 1995 and October 2006). n/a MAIN OUTCOME MEASURE(S): All-cause mortality was determined using the Social Security Death Index as of January 1, 2014. Causes of death were obtained from the National Death Index and classified as infective and parasitic diseases, neoplasms, respiratory system diseases, heart and blood vessel diseases, external causes, and other causes. Competing risks analysis, with time-dependent covariates, was performed with hazard ratios (HR) for each cause of death. The HRs for injury severity indicato...

Archives of physical medicine and rehabilitation, Jan 22, 2016

To document trends in the demographic and injury profile of new spinal cord injury (SCI) over tim... more To document trends in the demographic and injury profile of new spinal cord injury (SCI) over time. Cross-sectional analysis of longitudinal data by injury years (1972-1979, 1980-1989, 1990-1999, 2000-2009, 2010-2014). Twenty-eight Spinal Cord Injury Model Systems centers throughout the United States. Persons with traumatic SCI (N=30,881) enrolled in the National Spinal Cord Injury Database. Not applicable. Age, sex, race, education level, employment, marital status, etiology, and severity of injury. Age at injury has increased from 28.7 years in the 1970s to 42.2 years during 2010 to 2014. This aging phenomenon was noted for both sexes, all races, and all etiologies except acts of violence. The percentage of racial minorities expanded continuously over the last 5 decades. Virtually among all age groups, the average education levels and percentage of single/never married status have increased, which is similar to the trends noted in the general population. Although vehicular crashes...

Archives of Physical Medicine and Rehabilitation, Jan 9, 1995

To determine the relationship between early variables (initial Glasgow Coma Scale [GCS] scores, c... more To determine the relationship between early variables (initial Glasgow Coma Scale [GCS] scores, computed tomography [CT] findings, presence of skeletal trauma, age, length of acute hospitalization) and outcome variables (Functional Independence Measure [FIM] scores, rehabilitation length of stay [LOS], rehabilitation charges) in traumatic brain injury (TBI). Inception cohort. University tertiary care rehabilitation center. 91 patients with TBI. Inpatient rehabilitation. FIM, rehabilitation LOS, and rehabilitation charges. Patients in the severely impaired (GCS = 3 to 7) group showed significantly lower (p = .01) mean admission and discharge motor scores (21.26, 39.83) than patients in the mildly impaired (GCS = 13 to 15) group (38.86, 55.29). Cognitive scores were also significantly lower (p < .01) in the severely impaired group on admission (26.73 vs 54.14) and discharge (42.28 vs 66.48). These findings continued to be statistically significant (p < .01) after regression analysis accounted for the other early variables previously listed. Regression analysis also illustrated that longer acute hospitalization LOS was independently associated with significantly lower admission motor (p < .01) and cognitive (p = .05) scores, and significantly higher (p = .01) rehabilitation charges. Patients with CT findings of intracranial bleed with skull fracture had longer total LOS (70.88 vs 43.08 days; p < .05), rehabilitation LOS (30.01 vs 19.68 days; p < .10), and higher rehabilitation charges ($43,346 vs $25,780; p < .05). Paradoxically, those patients in a motor vehicle crash with an extremity bone fracture had significantly higher (p = .002; p = .04 after regression analysis) FIM cognitive scores on admission (48.30 vs 27.28) and discharge (64.74 vs 45.78) than those without a fracture. Finally, data available on rehabilitation admission were used to predict discharge outcomes. The percentage of explained variance for each outcome variable is as follows: discharge FIM motor score, 69.5%; discharge FIM cognitive score, 71.2%; rehabilitation LOS, 54.1%; rehabilitation charges, 61.1%. The most powerful predictor of LOS and charges was the admission FIM motor score (p < .001), followed by CT findings (p = .02) and age (p = .04). Information readily available on rehabilitation admission, particularly the FIM motor score, may be useful in predicting discharge FIM scores as well as utilization of medical rehabilitation resources. Earlier transfer to rehabilitation may result in higher functional status and lower rehabilitation charges, as well as lower acute hospitalization charges. The presence of extremity fractures encountered during a motor vehicle crash is associated with a more favorable outcome in TBI as evidenced by higher discharge FIM cognitive scores.