Hypothermia in Patients With Chronic Spinal Cord Injury

Khan, Sofia; Plummer, Mary L.; Martinez‐Arizala, Alberto; Banovac, K

doi:10.1080/10790268.2007.11753910

Cited by 59 publications

(37 citation statements)

References 20 publications

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“…The more frequently impaired thermoregulatory functions in people in the long-term context may be due to the higher proportion of in-patients among the early post-acute sample who may experience a more constant environmental temperature and thus are not challenged by managing variations in temperature. 13 The higher prevalence of Common problems of individuals with SCI using the ICF I Kirchberger et al Common problems of individuals with SCI using the ICF I Kirchberger et al problems regarding skin functions in the long-term context is supported by several studies reporting an increasing prevalence of pressure sores with time after injury.…”

Section: Discussionmentioning

confidence: 99%

Identification of the most common problems in functioning of individuals with spinal cord injury using the International Classification of Functioning, Disability and Health

Kirchberger¹,

Biering‐Sørensen

Charlifue

et al. 2009

Spinal Cord

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Study design: Cross-sectional, multicenter study. Objectives: To identify the most common problems of individuals with spinal cord injury (SCI) in the early post-acute and the long-term context, respectively, using the International Classification of Functioning, Disability and Health (ICF) as a frame of reference. Setting: International. Methods: The functional problems of individuals with SCI were recorded using the 264 ICF categories on the second level of the classification. Prevalence of impairment was reported along with their 95% confidence intervals. Data were stratified by context. Results: Sixteen study centers in 14 countries collected data of 489 individuals with SCI in the early post-acute context and 559 in the long-term context, respectively. Impairments in thirteen ICF categories assigned to Body functions and Body structures were more frequently reported in the longterm context, whereas limitations/restrictions in 34 ICF categories assigned to Activities and Participation were more frequently found in the early post-acute context. Eleven ICF categories from the component Environmental Factors were more frequently regarded as barriers, facilitators or both by individuals with SCI in the early post-acute context as compared with individuals with SCI in the long-term context. Only two environmental factors were more relevant for people with SCI in the long-term context than in the early post-acute context. Conclusion: The study identified a large variety of functional problems reflecting the complexity of SCI and indicated differences between the two contexts. The ICF has potential to provide a comprehensive framework for the description of functional health in individuals with SCI worldwide.

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Section: Discussionmentioning

confidence: 99%

Identification of the most common problems in functioning of individuals with spinal cord injury using the International Classification of Functioning, Disability and Health

Kirchberger¹,

Biering‐Sørensen

Charlifue

et al. 2009

Spinal Cord

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“…As mentioned previously, this phenomena of subnormal resting core body temperature in up to 66% of persons with SCI has been previously reported and is considered to be a result of thermoregulatory dysfunction. 16,22,32 Similar studies reporting subnormal resting core temperatures in the elderly and immunocompromised populations have caused clinicians to advocate for a lower and paraplegia through retrospective chart review of SCI inpatients with chronic SCI over 5 years.…”

Section: Baseline Temperaturesmentioning

confidence: 99%

“…21 Furthermore, reports of subnormal resting baseline temperatures have been reported by a few. [22][23][24][25] The largest cohort studied consisted of 50 persons with chronic tetraplegia, of whom 66% had resting core temperatures lower than 97.7°F in the absence of infection. 22 This relatively lower resting core temperature in the SCI versus non-SCI population has been previously attributed to failure of the mechanisms of heat conservation (ie, vasoconstriction) and production (ie, shivering) that require an intact spinal cord and its hypothalamic feedback.…”

Section: Does the Cdc Definition Of Fever Accurately Predict Inflammamentioning

confidence: 99%

“…[22][23][24][25] The largest cohort studied consisted of 50 persons with chronic tetraplegia, of whom 66% had resting core temperatures lower than 97.7°F in the absence of infection. 22 This relatively lower resting core temperature in the SCI versus non-SCI population has been previously attributed to failure of the mechanisms of heat conservation (ie, vasoconstriction) and production (ie, shivering) that require an intact spinal cord and its hypothalamic feedback. 14,15,[23][24][25] This subnormal resting core temperature, combined with impaired vasomotor and shivering responses in persons with SCI, has the potential to preclude core temperature elevation above 100.4°F to reach the CDC definition; however the literature is silent on this topic.…”

Section: Does the Cdc Definition Of Fever Accurately Predict Inflammamentioning

confidence: 99%

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Does the CDC Definition of Fever Accurately Predict Inflammation and Infection in Persons With SCI?

Trbovich¹,

Li²,

Lee³

2016

Topics in Spinal Cord Injury Rehabilitation

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Background: Pneumonia and septicemia have the greatest impact on reduced life expectancy in persons with spinal cord injury (SCI). Fever is often the first presenting symptom of infection or inflammation. Thermoregulatory dysfunction in persons with SCI may preclude a typical febrile response to infection or inflammation and thus delay diagnostic workup. Objective: To determine the core temperature of persons with SCI in the setting of infection or inflammation and the frequency with which it meets criteria for the CDC definition of fever (>100.4°F). Methods: Retrospective review of hospitalized SCI patients over 5 years with a diagnosis of infection or inflammation (DI), defined by serum leukocytosis. In this study, 458 persons with paraplegia (PP) and 483 persons with tetraplegia (TP) had 4,191 DI episodes. Aural temperatures (T au ) on the day of DI, 7 days prior, and 14 days afterwards were abstracted from medical records. Main outcome measures were average T au at DI, frequency of temperatures >100.4°F at DI, and average baseline temperatures before and after DI. Results: Average T au at DI was 98.2°F (±1.5) and 98.2°F (±1.4) in the TP and PP groups, respectively, with only 11.6% to 14% of DI resulting in T au >100.4°F. Baseline temperatures ranged from 97.9°F (±0.7) to 98.0°F (±0.8). Conclusion: SCI persons with leukocytosis infrequently mount a fever as defined by the CDC, and baseline temperatures were subnormal (<98.6°F). Thermoregulatory dysfunction likely accounts for these findings. T au >100.4°F is not a sensitive predictor of infection or inflammation in persons with SCI. Clinicians should be vigilant for alternative symptoms of infection and inflammation in these patients, so diagnostic workup is not delayed.

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“…3 The individual with SCI and especially those with cervical injury is poikilothermic and is at risk of developing hypothermia in low environmental temperature, even though hypothermia may also be seen in normal ambient temperature. 4 It is known that body temperature differs according to methods of measurement. 5 Hypohidrosis is usually seen below the level of lesion, whereas hyperhidrosis could be present above as well as below the level of lesion.…”

Section: Introductionmentioning

confidence: 99%

International Spinal Cord Injury Skin and Thermoregulation Function Basic Data Set

Krassioukov

Ms³

et al. 2012

Spinal Cord

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Hypothermia in Patients With Chronic Spinal Cord Injury

Abstract: Design: Retrospective analysis of medical records.Background/Objectives: To determine frequency and degree of hypothermic episodes in patients with chronic spinal cord injury (SCI).

Cited by 59 publications

References 20 publications

Identification of the most common problems in functioning of individuals with spinal cord injury using the International Classification of Functioning, Disability and Health

Identification of the most common problems in functioning of individuals with spinal cord injury using the International Classification of Functioning, Disability and Health

Does the CDC Definition of Fever Accurately Predict Inflammation and Infection in Persons With SCI?

International Spinal Cord Injury Skin and Thermoregulation Function Basic Data Set

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