Comparison of rehabilitation outcomes following vascular-related and traumatic spinal cord injury

William McKinley, Amit Sinha, Jessica McKinney Ketchum, Xiaoyan Deng

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

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.

Original languageEnglish (US)
Pages (from-to)410-415
Number of pages6
JournalJournal of Spinal Cord Medicine
Volume34
Issue number4
DOIs
StatePublished - Jul 1 2011

Fingerprint

Spinal Cord Injuries
Blood Vessels
Wounds and Injuries
Demography
Neurogenic Bowel
Length of Stay
Research Design
Rehabilitation
Outcome Assessment (Health Care)
Neurogenic Urinary Bladder
Pressure Ulcer
Trauma Centers
Paraplegia
Arteriovenous Malformations
Urinary Tract Infections
Hypotension
Dissection
Thorax
Morbidity
Pain

Keywords

  • Aortic dissection
  • Arteriovenous malformation
  • Functional independence measure
  • Post-surgical ischemia
  • Spinal cord injuries
  • Spinal cord ischemia
  • Systemic hypotension
  • Traumatic
  • Vascular
  • Vascular embolism

ASJC Scopus subject areas

  • Clinical Neurology

Cite this

Comparison of rehabilitation outcomes following vascular-related and traumatic spinal cord injury. / McKinley, William; Sinha, Amit; Ketchum, Jessica McKinney; Deng, Xiaoyan.

In: Journal of Spinal Cord Medicine, Vol. 34, No. 4, 01.07.2011, p. 410-415.

Research output: Contribution to journalArticle

McKinley, William ; Sinha, Amit ; Ketchum, Jessica McKinney ; Deng, Xiaoyan. / Comparison of rehabilitation outcomes following vascular-related and traumatic spinal cord injury. In: Journal of Spinal Cord Medicine. 2011 ; Vol. 34, No. 4. pp. 410-415.
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