Causes of death after spinal cord injury

Soden, R; Walsh, John; Middleton, JW; Craven, ML; Rutkowski, SB; Yeo, J. D.

doi:10.1038/sj.sc.3101080

Cited by 212 publications

(164 citation statements)

References 11 publications

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“…Some researchers have reported, perhaps counterintuitively, that people with high lesions have higher self-esteem and are more satisfied with their lives than people with incomplete or lower lesions [104][105][106] and that suicide rates among those with minimal impairments following SCI are nearly twice as high as among those with complete tetraplegia 107 (although the latter finding is not consistent across studies 108 ). While researchers have been at a loss to explain this paradox, it is possible that an inability to compete on an equal footing with able-bodied peers places particular distress upon those whose residual physical function suggests that this 'ought' to be attempted.…”

Section: Discussionmentioning

confidence: 99%

Quality of life among people with high spinal cord injury living in the community

Hammell¹

2004

Spinal Cord

110

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Study Design: An exploratory, qualitative methodology. Objectives: To explore perceptions of quality of life (QOL) among community-dwelling people with high spinal cord injuries (SCI) and the factors they identified as contributing to, enabling or constraining the quality of their lives. Setting: Urban communities on Vancouver Island and in the lower mainland of British Columbia, Canada. Methods: Semi-structured interviews with both men (n ¼ 11) and women (n ¼ 4) with complete high SCI (C1-C4). Interpretive analysis was grounded in the themes that arose from the interview transcripts. Results: Time since injury ranged from 4 to 28 years. The mean current age was 35 years, with a range from 21 to 50 years of age. High SCI disrupted not just a body but an entire biography of plans, daily activities and valued occupations. Initially feeling helpless and useless, the participants were unanimously glad to be alive at the time of the study and several described perceptions of very high QOL. The themes which emerged from the data were over-lapping and inter-dependent and described a process of refocusing values and re-establishing a view of the self as able and valuable following injury. The three primary themes addressed issues of autonomy, the meaningful use of time, and relationships. Conclusions: The study findings suggest that life with a high SCI can be rich and fulfilling if society is prepared to enable and support this; and that QOL outcomes might be maximized by adopting a biographical orientation to the rehabilitation process.

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Section: Discussionmentioning

confidence: 99%

Quality of life among people with high spinal cord injury living in the community

Hammell¹

2004

Spinal Cord

110

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“…8 In its place, cardiovascular disease has emerged as a major comorbidity, and hypertension is a major risk factor cardiovascular disease. [9][10][11] Plasma homocysteine, a thiol-containing amino acid formed by the demethylation of methionine, has been shown to be an indicator of cardiovascular risk. 12-14 A 5 mmol/l plasma homocysteine increment elevates the relative risk of coronary artery disease risk by a factor (40%) similar to that for an increase in serum cholesterol of 20 mg/dl.…”

Section: Introductionmentioning

confidence: 99%

Homocysteine and hypertension in persons with spinal cord injury

et al. 2005

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Study design: Cross-sectional analysis of a convenience sample of locally recruited participants, including both patients and volunteers. Objectives: To determine whether there is an association between plasma homocysteine and hypertension in persons with spinal cord injury (SCI). Setting: Spinal Cord Injury Service of the Veterans Affairs Palo Alto Medical Center (California, United States of America). Methods: The incidence of hypertension, dyslipidemia, insulin resistance, and the presence of metabolic syndrome were determined in 168 individuals with SCI (mean age 50.2712.8 years). Fasting lipids, insulin, glucose, plasma homocysteine, and anthropometric data was gathered for each subject. Results: Blood pressure values (Po0.001) and mean arterial pressure (Po0.05) increased with higher plasma homocysteine levels. Homocysteine values were also significantly greater among individuals with hypertension compared with those who were normotensive or prehypertensive (Po0.0001). There was an inverse relationship between plasma homocysteine levels and glomerular filtration rate and effective renal plasma flow (Po0.05). Conclusions: Plasma homocysteine levels are elevated in persons with SCI who have hypertension and inversely related to renal function, which suggests that renal dysfunction may be a link between homocysteine and hypertension in persons with SCI.

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“…The remaining 16 are listed in Table 1. 1,2,5,[11][12][13][14][15][16][17][18][19][20][21][22][23] The table shows the absence of PE in autopsy surveys, a very low prevalence of PE as a cause of death or even in survivors of SCI registered for continuing care, but a relatively high prevalence of PE in the records screened by electrocardiogram (ECG). Reasons for these discrepancies are discussed below.…”

Section: Pe Prevalence In Chronic Scimentioning

confidence: 99%

The prevalence of pulmonary embolism in chronically paralyzed subjects: a review of available evidence

Frisbie¹,

Sharma

2011

Spinal Cord

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Study design: Qualitative systematic review. Objectives: To examine the validity of the prevailing notion that pulmonary embolism (PE) is rare in the chronic spinal cord injury (SCI) population. Setting: USA. Methods: Review surveys of adult SCI subjects 42 months after injury in which PE has been looked for and its prevalence estimated. Results: A total of 16 surveys of chronic SCI subjects published between 1956 and 2009 offered data on PE prevalence. Two autopsy surveys, 178 subjects paralyzed 42 months, revealed no PE. Eleven surveys of the cause of death, 3193 subjects paralyzed 1-25 years, revealed PE in 2.1%. Two surveys of survivors of SCI, 5761 subjects paralyzed 1-25 years, revealed PE in 0.4%. Our survey of 112 subjects paralyzed 1-50 years before death, revealed PE in 21 (18.7%), based on autopsy, imaging, clinical and electrocardiographic evidence. In 7 (33%) of the 21 subjects with PE, pulmonary hypertension by transthoracic echocardiography was detected, indicating recurrent and/or unresolved PE. Conclusion: PE is not infrequent in the chronic SCI subject; but its presentation may be subclinical; and its apparent recurrence may lead to pulmonary hypertension.

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Causes of death after spinal cord injury

Cited by 212 publications

References 11 publications

Quality of life among people with high spinal cord injury living in the community

Quality of life among people with high spinal cord injury living in the community

Homocysteine and hypertension in persons with spinal cord injury

The prevalence of pulmonary embolism in chronically paralyzed subjects: a review of available evidence

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