TY - JOUR
T1 - Comparison of rehabilitation outcomes following vascular-related and traumatic spinal cord injury
AU - McKinley, William
AU - Sinha, Amit
AU - Ketchum, Jessica
AU - Deng, Xiaoyan
N1 - Copyright:
Copyright 2011 Elsevier B.V., All rights reserved.
PY - 2011/7
Y1 - 2011/7
N2 - Background: Previous studies have noted similar outcomes between vascular-related spinal cord injury (VR-SCI) and those with traumatic SCI (T-SCI), despite significant difference in their demographics and clinical presentation (age, level of injury (LOI), and degree of incompleteness). Objectives: To review demographic and clinical presentation of VR-SCI and to compare outcomes with a matched group with T-SCI. Design: Analysis of 10-year prospective data collection including 30 consecutive patients admitted to an SCI rehabilitation unit with VR-SCI and comparison with 573 patients with T-SCI. Outcomes were further analyzed comparing VR-SCI to T-SCI (n = 30), matched for age, LOI, and ASIA (American Spinal Injury Association) Impairment Scale (AIS). Setting: A level 1 tertiary university trauma center. Main outcome measures: Functional independence measure (FIM) score changes from admission to discharge. Secondary outcome measures included admission and discharge FIM scores, FIM efficiency, rehabilitation length of stay (LOS), and discharge disposition. Results: Overall, individuals with VR-SCI were more likely (P < 0.0001) to be older (mean age 57.2 vs. 40.0 years) and have paraplegia (87 vs. 48%) than those with T-SCI. Common etiologies for VR-SCI were post-surgical complication (43%), arteriovenous malformation (17%), aortic dissection (13%), and systemic hypotension (13%). Common region of injury and AIS classification in VR-SCI was thoracic (73%) and AIS C (33%). Common SCI-related complications in VR-SCI included neurogenic bowel/bladder (93%), urinary tract infection (73%), pain (67%), pressure ulcers (47%), and spasticity (20%). Matched-group outcome comparisons did not reveal significant differences in FIM change, FIM efficiency, LOS, or disposition between VR-SCI and T-SCI. Conclusion: VR-SCI leads to significant disability and is associated with common secondary SCI complications as well as medical co-morbidities. This study notes differing demographic and injury characteristics between VR-SCI and T-SCI groups. However, when matched for these differences, rehabilitation functional outcomes were not significantly different between the two groups.
AB - Background: Previous studies have noted similar outcomes between vascular-related spinal cord injury (VR-SCI) and those with traumatic SCI (T-SCI), despite significant difference in their demographics and clinical presentation (age, level of injury (LOI), and degree of incompleteness). Objectives: To review demographic and clinical presentation of VR-SCI and to compare outcomes with a matched group with T-SCI. Design: Analysis of 10-year prospective data collection including 30 consecutive patients admitted to an SCI rehabilitation unit with VR-SCI and comparison with 573 patients with T-SCI. Outcomes were further analyzed comparing VR-SCI to T-SCI (n = 30), matched for age, LOI, and ASIA (American Spinal Injury Association) Impairment Scale (AIS). Setting: A level 1 tertiary university trauma center. Main outcome measures: Functional independence measure (FIM) score changes from admission to discharge. Secondary outcome measures included admission and discharge FIM scores, FIM efficiency, rehabilitation length of stay (LOS), and discharge disposition. Results: Overall, individuals with VR-SCI were more likely (P < 0.0001) to be older (mean age 57.2 vs. 40.0 years) and have paraplegia (87 vs. 48%) than those with T-SCI. Common etiologies for VR-SCI were post-surgical complication (43%), arteriovenous malformation (17%), aortic dissection (13%), and systemic hypotension (13%). Common region of injury and AIS classification in VR-SCI was thoracic (73%) and AIS C (33%). Common SCI-related complications in VR-SCI included neurogenic bowel/bladder (93%), urinary tract infection (73%), pain (67%), pressure ulcers (47%), and spasticity (20%). Matched-group outcome comparisons did not reveal significant differences in FIM change, FIM efficiency, LOS, or disposition between VR-SCI and T-SCI. Conclusion: VR-SCI leads to significant disability and is associated with common secondary SCI complications as well as medical co-morbidities. This study notes differing demographic and injury characteristics between VR-SCI and T-SCI groups. However, when matched for these differences, rehabilitation functional outcomes were not significantly different between the two groups.
KW - Aortic dissection
KW - Arteriovenous malformation
KW - Functional independence measure
KW - Post-surgical ischemia
KW - Spinal cord injuries
KW - Spinal cord ischemia
KW - Systemic hypotension
KW - Traumatic
KW - Vascular
KW - Vascular embolism
UR - http://www.scopus.com/inward/record.url?scp=80051501275&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=80051501275&partnerID=8YFLogxK
U2 - 10.1179/2045772311Y.0000000016
DO - 10.1179/2045772311Y.0000000016
M3 - Article
C2 - 21903015
AN - SCOPUS:80051501275
SN - 1079-0268
VL - 34
SP - 410
EP - 415
JO - Journal of Spinal Cord Medicine
JF - Journal of Spinal Cord Medicine
IS - 4
ER -