Adults With Pediatric-Onset Spinal Cord Injuries: Part 3: Impact Of Medical Complications

The Journal of Spinal Cord Medicine

2011

Self Cite

Objective: To identify outcomes of participation, life satisfaction, and medical complications as a function of impairment in adults with pediatric-onset spinal cord injury (SCI). Methods: Study participants were adults who sustained SCI at age 18 years or younger and were interviewed at age 24 years or older (M = 26.9, SD = 3.5). The telephone interview included a questionnaire and several standardized measures: Craig Handicap Assessment and Reporting Technique (CHART), SF-12® Health Survey, and Satisfaction with Life Scale. Using the International Standards for Neurological Classification of Spinal Cord Injury and the American Spinal Injury Association (ASIA) Impairment Scale (AIS), subjects were grouped into four impairment categories: C1-C4 ABC, C5-C8 ABC, T1-L4 ABC, and AIS D. Results: Of the 410 participants, 62% were male, 54% had tetraplegia, 70% had AIS A lesions, and average age at injury was 14 years (SD = 4.3). Of the 407 subjects who had complete neurological information, 59 had C1-C4 ABC, 140 had C5-C8 ABC, 168 had T1-L4 ABC, and 40 had AIS D lesions. The outcomes were delineated for education, employment, independent living and driving, marriage, participation, medical complications, healthrelated quality of life, and global life satisfaction, in addition to the ASIA motor score and FIM ® motor scores, for each of the four impairment groups. Conclusions: This information should help focus interventions that facilitate positive outcomes in relationship to the severity of impairment. In addition, these data can provide a level of expectation about long-term outcomes for newly injured children and their parents.

Section: Discussionmentioning

confidence: 97%

Long-term outcomes of adults with pediatric-onset spinal cord injuries as a function of neurological impairment

Chlan

Zebracki

The Journal of Spinal Cord Medicine

2011

Self Cite

“…The present study is part of a larger follow-up study that has been ongoing for the past decade (1)(2)(3)(4)(5). Of the 864 subjects eligible for this overall study, 353 (41%) completed interviews, 11% were lost to follow-up, 5% had died, 10% refused, and for 33% attempts to contact them are still being conducted.…”

Section: Participantsmentioning

confidence: 99%

“…Identifying the adult outcomes of these individuals and the risk factors associated with poorer outcomes is a step toward understanding how pediatric rehabilitation for these patients can be improved (1)(2)(3)(4)(5). One important outcome to address is the emotional status of the individual as an adult, and specifically, whether there is significant depression.…”

Section: Introductionmentioning

confidence: 99%

Depression in Adults Who Sustained Spinal Cord Injuries as Children or Adolescents

The Journal of Spinal Cord Medicine

Vogel

Chlan

et al. 2007

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Study design: Interview survey.Objective: To assess depression in adults with pediatric-onset spinal cord injuries (SCI) and to determine demographic and injury-related factors, and outcomes associated with depression, and to determine which other outcomes are associated with depression.Methods: Subjects were adults with pediatric-onset SCI who sustained SCI at age 18 years and were interviewed at age !24 years. This is part of a longitudinal study for which there were 864 eligible participants; 353 (41%) were interviewed. Of these, 232 were assessed for depression. A telephone interview was conducted that included a structured questionnaire and standardized measures (Functional Independence Measure, Craig Handicap Assessment and Reporting Technique, Short-Form 12 measure of healthrelated quality of life, Satisfaction with Life Scale, and Patient Health Questionnaire-9 to screen for depression).Results: Twenty-seven percent reported depressive symptoms ranging from mild to severe, and 7% reported having suicidal thoughts within the last 2 weeks, and 3% reported symptoms consistent with probable major depressive disorder (MDD). Depression was not significantly associated with any demographic factors but it was associated with incomplete injury (P ¼ 0.013). Depression was also associated with many participation outcomes, health-related quality of life, life satisfaction, and medical complications.Conclusions: Depression is a significant problem among adults with pediatric-onset SCI and is associated with poorer outcomes and lower quality of life. These findings should be addressed as clinicians prepare children and adolescents with SCI to transition to adulthood. Spinal Cord Med. 2007;30:S76-S82 J

“…Medical complications, for example, had a significant association with overall life satisfaction in this population. 32 Satisfaction with dating, for which the factors in the regression model accounted for only 10% of the variance, is likely to be associated with societal and personal factors that were not included in this study. 33 Further research is needed to explore the role of psychological, societal, and environmental factors on outcomes, including overall life satisfaction and satisfaction in various domains.…”

Section: Discussionmentioning

confidence: 94%

Domain-specific satisfaction in adults with pediatric-onset spinal cord injuries

2003

Spinal Cord

Study design: Interview using a structured questionnaire and standardized measures. Objectives: To determine domain-specific satisfaction levels in adults with pediatric-onset spinal cord injuries (SCI), to determine factors associated with these levels of satisfaction, and to determine the relationship of domain-specific satisfaction to overall life satisfaction in this population. Setting: US and Canada. Methods: The participants were adults who sustained SCI at age 18 years or younger and were 24 years of age or older at the time of interview and did not have significant head injury. In addition to providing information about themselves, including education level, employment, marital status, and community participation, they were asked to rate their level of satisfaction in seven domains: transportation in the community, educational achievement, employment opportunities, income, social/recreational opportunities, dating opportunities, and sexual experience. They also completed the satisfaction with life scale (SWLS), the Craig handicap assessment and reporting technique, the functional independence measure, and the short-form-12 perceived health scale. Results: A total of 216 individuals were interviewed. The mean age at injury was 14 years and the mean age at interview was 29 years. From most satisfied to least satisfied, the domains were ranked in the following order: satisfaction with transportation in the community, educational achievement, social and recreational opportunities, sexual experiences, dating opportunities, job opportunities, and income. Age at interview, gender, and perceived health were identified in regression analyses as predictors of some of the domain-specific satisfactions, but the primary predictive factors were in the area of participation. Neither severity of neurologic impairment nor level of functional independence were predictors for any of the domains. Satisfaction in each of the domains was significantly associated with SWLS and satisfaction with dating, job opportunities, education, and income were identified as predictive factors in a regression analysis. Conclusions: Dating opportunities, job opportunities, and income are the three domains in which adults with pediatric-onset SCI are least satisfied and those domains have a significant impact on overall satisfaction.