The Swedish SPinal Cord Injury Study on Cardiopulmonary and Autonomic Impairment

Abstract

Objective The aim of the study was to present the methodology, cohort demographics, and initial results of the Swedish SPinal Cord Injury Study on Cardiopulmonary and Autonomic Impairment (SPICA). Design The SPICA is based on the Swedish CArdioPulmonary BioImage Study, a study on cardiopulmonary diseases in a cohort of 30,000 people. The assessments in the SPICA cover the structure and function of the cardiopulmonary and autonomic systems using bioimaging and functional analyses, together with a study-specific questionnaire and generic and spinal cord injury–specific assessment tools. The inclusion criteria were as follows: age 50–65 yrs, traumatic spinal cord injury of 5 yrs or more, and injury levels C1-T6, American Spinal Injury Association Impairment Scale A–C. Results Of 38 potential participants, 25 comprised the final sample (20% women, mean age 58 yrs, mean time since injury 28 yrs). Eight percent had sustained a cardiovascular event, and 72% were classified as a high risk for cardiovascular disease. Asthma was previously diagnosed in only 8%, and none had chronic obstructive pulmonary disease. Conclusions The risk for cardiovascular disease in people with severe high-level spinal cord injury is a major clinical concern. Forthcoming studies in the SPICA will provide new knowledge of cardiopulmonary health in this cohort, which can guide future research and be used to develop long-term management.

Coronary and carotid imaging of atherosclerosis and contributing factors in middle‐aged people with long‐term cervical and upper thoracic spinal cord injuries

“…We have previously concluded that the participants in the SCI unit's registries represent the SCI population in the geographical area. 10 The representativeness of the SCAPIS control group has also been demonstrated as compared with a random sample of the target population. 20 Moreover, the identical data collection and analyses in both the participants and controls minimized bias.…”

“…The rationale to target this subpopulation of people with SCI has been discussed elsewhere. 10 A total of 38 people met the inclusion criteria and 25 people consented to participate. As there were no significant differences between the 25 participants and the 13 nonparticipants regarding gender, age, NLI, AIS grade, age at injury, and time since injury, we have concluded that our sample is likely to represent the population of middle-aged people with cervical and upper thoracic SCI in the Skåne region, Sweden.…”

“…As there were no significant differences between the 25 participants and the 13 nonparticipants regarding gender, age, NLI, AIS grade, age at injury, and time since injury, we have concluded that our sample is likely to represent the population of middle-aged people with cervical and upper thoracic SCI in the Skåne region, Sweden. 10…”

“…Therefore, to contribute to our knowledge base of cardiopulmonary health in middle-aged people with long-term cervical and upper thoracic SCI, we initiated the Swedish SPinal Cord Injury Study on Cardiopulmonary and Autonomic Impairment (SPICA). 10 In previous studies, we have presented the methodology, cohort demographics and initial results, 10 and the functional and structural impairments of the pulmonary system. 11 In the present study of SPICA, the objectives are (1) to describe the occurrence of coronary and carotid atherosclerosis using CCTA, coronary artery calcium and carotid ultrasound, and CVD risk factors (blood pressure [BP], total and non-high density lipoprotein [HDL] cholesterol, glucose, C-reactive protein [CRP], Systematic Coronary Risk Evaluation [SCORE] and anthropometry) in people with long-term SCI, and (2) to compare the findings of this SCI cohort with the general population.…”

Predictors of hospital-acquired pressure injuries in patients with complete spinal cord injury: a retrospective case–control study

“…Change in autonomic nervous system function in the acute phase of SCI may be especially relevant, particularly neurogenic shock, cardiac dysrhythmias, orthostatic hypotension, autonomic dysreflexia, temperature dysregulation, and hyperhidrosis [ 17 ]. Autonomic dysreflexia in SCI exerts insidious effects on cardiac function [ 18 ], and may provide an etiological link to the higher risk of heart disease in SCI [ 19 , 20 ].…”