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  4. Cardiovascular and metabolic morbidity following spinal cord injury

Cardiovascular and metabolic morbidity following spinal cord injury

Spine J, 2021 · DOI: 10.1016/j.spinee.2021.05.014 · Published: September 1, 2021

Spinal Cord InjuryCardiovascular ScienceEndocrinology

Simple Explanation

Individuals with spinal cord injuries are at a higher risk for developing chronic health conditions. These conditions can be secondary to the injury itself or influenced by the aging process. This study compares the occurrence of cardiovascular and metabolic (cardiometabolic) diseases in adults with spinal cord injuries to those without. It uses data from a large insurance claims database. The findings suggest that adults with spinal cord injuries have a significantly higher risk of developing cardiometabolic diseases. This highlights the need for better screening and early interventions to reduce this risk.

Study Duration
5 Years
Participants
9,081 adults with traumatic SCI and 1,474,232 adults without SCI
Evidence Level
Longitudinal cohort study

Key Findings

  • 1
    Adults with traumatic SCIs had a higher 5-year incidence of any cardiometabolic morbidities (56.2% vs. 36.4%) compared to adults without SCI.
  • 2
    Adults with SCI had a greater hazard for any cardiometabolic morbidity (Hazard Ratio [HR]: 1.67; 95%CI: 1.58, 1.76).
  • 3
    Fully adjusted survival models demonstrated that adults with SCI had a greater hazard for any cardiometabolic morbidity (HR: 1.29; 95%CI: 1.22–1.36).

Research Summary

This study examined the incidence and risk of cardiometabolic morbidities in adults with spinal cord injuries (SCI) compared to those without SCI using a large, nationwide insurance claims database. The results indicated that adults with SCI have a significantly higher incidence of and risk for common cardiometabolic morbidities, including cardiac dysrhythmias, heart failure, atherosclerosis, and diabetes. The study concludes that increased clinical awareness, improved screening strategies, and efficient referral resources are needed to reduce the burden of cardiovascular and metabolic health disorders in individuals with SCI.

Practical Implications

Improved Clinical Screening

Development of improved clinical screening algorithms for early detection of cardiometabolic diseases in SCI patients.

Early Interventions

Implementation of targeted, early interventions to reduce the risk of disease progression and multimorbidity in this vulnerable population.

Healthcare Resource Allocation

Efficient referral resources for coordinated care to help reduce the burden of cardiovascular and metabolic health disorders in SCI patients.

Study Limitations

  • 1
    The ICD-9 and ICD 10 codes for the traumatic SCI diagnosis do not differentiate between a Complete and Incomplete SCI.
  • 2
    The study cannot rule out time-varying confounding effects since baseline measurements of all covariates were included in the final models.
  • 3
    The Clinformatics DataMart Database only provided private health insurance claim data for study extraction.

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