Effect of body mass index on survival after spinal cord injury

Frontiers in Neurology, 2024 · DOI: 10.3389/fneur.2023.1269030 · Published: January 26, 2024

Spinal Cord Injury Physiology Public Health

Simple Explanation

This study looks at how body mass index (BMI) affects survival rates after a spinal cord injury (SCI). It aims to understand if being underweight or overweight at the time of injury impacts how long a person lives after the injury. The study found that people who were underweight at the time of their spinal cord injury had a higher risk of dying within the next 7.7 years. On the other hand, those with a higher BMI had a slightly lower risk of death. These findings suggest that a person's weight at the time of a spinal cord injury can affect their chances of survival. Further research is needed to understand why this happens and how to improve survival rates for all SCI patients.

Study Duration

Up to 7.7 years

Participants

643 patients with traumatic SCI

Evidence Level

Prospective longitudinal cohort study

Key Findings

1
Underweight individuals (BMI < 17.5 kg/m²) had a significantly elevated risk of mortality (HR 5.55, 95% CI 2.34–13.17, p < 0.001) compared to the mid-range BMI group (17.5–30.5 kg/m²).
2
High BMI (BMI > 30.5 kg/m²) showed a significant decrease in mortality risk (HR 0.28, 95% CI 0.09–0.88, p = 0.029) compared to the mid-range BMI group.
3
Mortality risk from 1 month to 7.7 years after SCI was associated with BMI at admission, independent of factors like age, sex, injury severity, and comorbidities.

Research Summary

This study investigated the impact of body mass index (BMI) at admission on mortality rates in patients with traumatic spinal cord injury (SCI) over a period of up to 7.7 years. The study found that being underweight (BMI < 17.5 kg/m²) at admission was a significant risk factor for mortality, while a higher BMI (> 30.5 kg/m²) had a mild protective effect. These findings suggest that BMI at the time of injury is associated with long-term survival after SCI, highlighting the potential importance of nutritional status in these patients.

Practical Implications

Nutritional Support

Implement early nutritional support for underweight SCI patients to improve survival outcomes.

Weight Management Strategies

Develop weight management strategies for SCI patients to optimize BMI and potentially reduce mortality risk.

Further Research

Conduct further research to understand the underlying mechanisms linking BMI and mortality in SCI patients.

Study Limitations

1
Not population-based, potential bias in catchment area and representation of ethnic minorities/rural populations.
2
Missing data and use of self-reported data (height and weight) may introduce bias.
3
Small sample size (n=12) for the BMI < 17.5 kg/m² group, reported effect estimates should be interpreted cautiously.

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