Frequency and age effects of secondary health conditions in individuals with spinal cord injury: a scoping review

Abstract

Study design: Scoping review. Objectives: To gain a better understanding of the prevalence, course and association with age of secondary health conditions in individuals with spinal cord injury (SCI). Setting: Seattle, Washington, USA. Methods: We performed searches of electronic databases for studies published from 1986-2011 that provided information regarding the prevalence, course or associations with age and duration of secondary health conditions in individuals with SCI. Results: Ninety-two studies were included. The findings indicate that: (1) individuals with SCI experience a number of secondary health conditions, many of which occur at a higher rate in those with SCI than the normative population; (2) the most common conditions or symptoms are pain, bowel and bladder regulation problems, muscle spasms, fatigue, esophageal symptom and osteoporosis; (3) a number of conditions, including cardiovascular disease, diabetes, bone mineral density loss, fatigue and respiratory complications or infections, occur with higher frequency in older individuals or those with longer SCI duration, relative to younger individuals or those with shorter SCI duration; and (4) there is a marked lack of longitudinal research examining the natural course of health conditions in individuals aging with SCI. Conclusions: The findings support the conclusion that individuals with SCI show signs of 'premature aging' in different organ systems. Longitudinal research is needed to understand when problems are most likely to emerge, and to develop and test the efficacy of interventions to prevent these health conditions and their negative impact.

Medical complications during pregnancy and childbirth in women with SCI in Switzerland

“…The list was developed by considering the current literature and by involving health providers who had cared for pregnant women with SCIs. 25 The questionnaire specifically asked about skin problems, bowel function, UTI frequency, mode of delivery, decubital ulcers, hospital admissions, alterations in medication, respiratory tract problems and changes in neurogenic lower urinary tract dysfunction symptoms.…”

Medication-related problems in individuals with spinal cord injury in a primary care-based clinic

“…4 Many of these conditions consequently are managed with pharmacotherapy. A prospective study in Denmark that investigated medication use among 72 patients admitted with a spinal cord lesion found that medication consumption increased 3.29-fold relative to that before SCI.…”

Hospital-acquired pressure ulcers in spinal cord injured patients: time to occur, time until closure and risk factors

“…8,25 Economic and politic factors, ethical considerations, vision of the institution and caregivers in the Swiss health-care system influence this rate, allowing patients an ongoing in-house treatment until closure. 7,22 Although occurrence of PU is often discussed as an indicator of worse outcome and discharge destination, 4,7 closure of HAPU did not change the discharge destination in our population.…”

“…12,22 Focussing on highest occurrence per patient-years, our orthopaedic SCI patients had more HAPUs in the immediate postoperative period than non-SCI patients (25% versus 5%) 14 and a similar rates after 5 days of surgery (66.7% versus 58%). 14 Even though surgery is of influence, not all patterns can be explained; for example, low incidences in patients admitted for deep PUs that were almost all surgically closed.…”

“…The significant, positive association with time since injury (P = 0.005) is corresponding with results found in literature. 11,15,22 Time until closure The therapeutic goal and principles of treatment usually lead to healing of a PU ulcer during hospitalisation. The rehabilitation team and patients decided for conservative treatment of all HAPUs, even though plastic surgery was easily accessible.…”