Abstract
Objective
To assess lifetime prevalence of 7 chronic health conditions (CHCs) among a cohort
of adults with chronic traumatic spinal cord injury (SCI).
Design
Cross-sectional.
Setting
Rehabilitation hospital.
Participants
Adults with SCI who were ≥18 years of age, were ≥1 year postinjury, and had residual
neurologic effects impeding full recovery (n=1678).
Interventions
Not applicable.
Main Outcome Measures
CHCs were measured using questions from the Behavioral Risk Factor Surveillance System
for diabetes (not including gestational), heart attack (also called a myocardial infarction),
angina or coronary artery disease, stroke, hypertension (not including during pregnancy),
high blood cholesterol, or cancer.
Results
Of participants, 49.5% reported having at least 1 CHC, with 23.2% reporting ≥2 CHCs.
The most frequently reported CHC was high cholesterol (29.3%) followed by hypertension
(28.7%) and diabetes (11.8%). Although the prevalence of CHCs significantly increased
with increasing age, only hypertension and cancer were significantly associated with
years postinjury. Four CHCs (diabetes, coronary artery disease, hypertension, high
cholesterol) were significantly related to mobility status as measured by injury level
and ambulatory status. However, after controlling for age, years postinjury, sex,
and race, mobility status became nonsignificant in relation to coronary artery disease,
but it remained significantly associated with diabetes, hypertension, and high cholesterol.
Conclusions
Clinicians should be aware of the risk of CHCs in persons with SCI and should screen
for these conditions and regular maintenance activities related to SCI.
Keywords
List of abbreviations:
BRFSS (Behavioral Risk Factor Surveillance System), CHC (chronic health condition), CVD (cardiovascular disease), MCC (multiple chronic conditions), SCI (spinal cord injury)To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Archives of Physical Medicine and RehabilitationAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Spinal cord injury facts and figures at a glance.Univ of Alabama, Birmingham2013
- Spinal cord injuries.Med J Armed Forces India. 2010; 66: 325-328
- 10 leading causes of death by age group, United States - 2010.2010 (Available at:) (Accessed July 7, 2013)
- Recent trends in mortality and causes of death among persons with spinal cord injury.Arch Phys Med Rehabil. 1999; 80: 1411-1419
- A conceptual model for identifying, preventing, and managing secondary conditions in people with disabilities.Phys Ther. 2011; 91: 1728-1739
- An evidence-based review of aging of the body systems following spinal cord injury.Spinal Cord. 2011; 49: 684-701
- 31st G. Heiner sell lectureship: secondary medical consequences of spinal cord injury.Top Spinal Cord Inj Rehabil. 2012; 18: 354-378
- Frequency and age effects of secondary health conditions in individuals with spinal cord injury: a scoping review.Spinal Cord. 2013; 51: 882-892
- Perceived barriers to exercise in people with spinal cord injury.Am J Phys Med Rehabil. 2005; 84: 576-583
- Chronic conditions among Medicare beneficiaries, chartbook.(Baltimore: Center for Medicare and Medicaid Services)2012
National Quality Forum. MCC measurement framework. 2012. Available at: http://www.qualityforum.org/Projects/Multiple_Chronic_Conditions_Measurement_Framework.aspx. Accessed April 2014.
- Health of community-dwelling adults with mobility limitations in the United States: incidence of secondary health conditions. Part II.Arch Phys Med Rehabil. 2008; 89: 219-230
- The complex web of health: relationships among chronic conditions, disability, and health services.Public Health Rep. 2011; 126: 495-507
- Causes of death during the first 12 years after spinal cord injury.Arch Phys Med Rehabil. 1993; 74: 248-254
- Long term survival and causes of death.in: Stover S.L. DeLisa J.A. Whiteneck G.G. Spinal cord injury: clinical outcomes from the model systems. Aspen, Gaithersburg1995: 289-316
- Transitional cell carcinoma in patients with spinal cord injury: a high risk malignancy?.Urology. 2002; 59: 240-244
- Risk and protective factors for secondary conditions: a 15-year longitudinal study.Top Spinal Cord Inj Rehabil. 2010; 16: 22-29
- The relationship of pressure ulcers, race, and socioeconomic conditions after spinal cord injury.J Spinal Cord Med. 2010; 33: 387-395
- Psychological factors affecting alcohol use after spinal cord injury.Spinal Cord. 2011; 49: 637-642
- Risk of mortality and life expectancy after spinal cord injury: the role of health behaviors and participation.Top Spinal Cord Inj Rehabil. 2010; 16: 53-60
Centers for Disease Control and Prevention, Office of Surveillance, Epidemiology, and Laboratory Services. Behavioral Risk Factor Surveillance System: prevalence and trends data—Georgia 2012. 2012. Available at: http://apps.nccd.cdc.gov/brfss/page.asp?yr=2012&state=GA&cat=CH#CH. Accessed April 2014.
- A prospective assessment of mortality in chronic spinal cord injury.Spinal Cord. 2005; 43: 408-416
- The clinical problems in cardiovascular control following spinal cord injury: an overview.Prog Brain Res. 2006; 152: 223-229
- The effect of residual neurological deficit on serum lipoproteins in individuals with chronic spinal cord injury.Spinal Cord. 1998; 36: 13-17
- Health behaviors among American Indians with spinal cord injury: comparison with data from the 1996 Behavioral Risk Factor Surveillance System.Arch Phys Med Rehabil. 1999; 80: 1435-1440
- A comparison of health behaviors between African Americans with spinal cord injury and those in the general population.NeuroRehabilitation. 2013; 33: 449-456
- Baseline prevalence of heart diseases, hypertension, diabetes, and obesity in persons with acute traumatic spinal cord injury: potential threats in the recovery trajectory.Top Spinal Cord Inj Rehabil. 2013; 19: 172-182
Article info
Publication history
Published online: December 09, 2014
Footnotes
Supported by the Department of Education, National Institute on Disability and Rehabilitation Research (grant nos. H133B090005 and H133G090059). However, the contents do not necessarily represent the policy of the Department of Education, and you should not assume endorsement by the Federal Government.
Disclosures: none.
Identification
Copyright
© 2015 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
