In-hospital mortality of all patients admitted to the study center after acute tSCI from 2011 to 2017 was assessed. This retrospective cohort study aims at identifying relevant comorbidities and explores the influence of end-of-life decisions. scores are important predictors of in-hospital mortality after traumatic spinal cord injury (tSCI), but the impact of specific pre-existing diseases is unknown. 12 QUEST-Center for Transforming Biomedical Research, Berlin Institute of Health (BIH), Anna-Louisa-Karsch-Str. 11 Clinical and Experimental Spinal Cord Injury Research (Neuroparaplegiology), Department of Neurology With Experimental Neurology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Charitéplatz 1, 10117, Berlin, Germany.10 Department of Traumatology, University of Greifswald, Sauerbruchstraße, 17491, Greifswald, Germany.9 Belford Center for Spinal Cord Injury, Departments of Neuroscience and Physical Medicine and Rehabilitation, The Neurological Institute, The Ohio State University, Wexner Medical Center, Columbus, OH, USA.8 Spinal Cord Injury Medicine (Neuroparaplegiology), Department of Neurology, The Ohio State University, Wexner Medical Center, Columbus, OH, USA.7 Clinical and Experimental Spinal Cord Injury Research (Neuroparaplegiology), Department of Neurology With Experimental Neurology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Charitéplatz 1, 10117, Berlin, Germany.6 Berlin Institute of Health (BIH), Anna-Louisa-Karsch-Str.5 Institute of Biometry and Clinical Epidemiology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Charitéplatz 1, 10117, Berlin, Germany.4 Clinic for Trauma Surgery and Orthopedics, Trauma Hospital Berlin, Warener Str.3 Treatment Center for Spinal Cord Injuries, Trauma Hospital Berlin, Warener Str. 2 QUEST-Center for Transforming Biomedical Research, Berlin Institute of Health (BIH), Anna-Louisa-Karsch-Str. 1 Clinical and Experimental Spinal Cord Injury Research (Neuroparaplegiology), Department of Neurology With Experimental Neurology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Charitéplatz 1, 10117, Berlin, Germany.