Abstract
Objective
To identify the relationships of behavioral factors with unintentional injuries among
participants with traumatic spinal cord injury (SCI).
Design
Cross-sectional.
Setting
Medical university in the Southeastern United States.
Participants
Participants (N=4670) met the following inclusion criteria: traumatic SCI of at least
1-year duration, minimum of 18 years of age, and residual impairment from SCI (noncomplete
recovery). Of these, 2516 were identified from a specialty hospital and 2154 were
identified from population-based state surveillance systems.
Interventions
Not applicable.
Main Outcome Measures
Participants completed self-report assessments including multiple behavioral variables,
SCI variables, and demographic characteristics. Primary outcome was unintentional
injuries during the past 12 months.
Results
Twenty-three percent (n=969) reported at least 1 unintentional injury in the past
year serious enough to receive medical care in a clinic, emergency department, or
hospital, and the average number of times injured was 1.82 among those with at least
1 injury. Prescription medication use for pain and depression, nonmedical medication
use, use of prescription medication for purposes other than prescribed, and binge
drinking were associated with a greater odds of unintentional injury. There were some
differences between fall-related and non–fall-related unintentional injuries, with
ambulation associated with greater odds of fall-related injuries but lower odds of
non–fall-related injuries. Participants identified through population-based systems
were at greater risk of falls compared with those identified through a traditional
specialty hospital.
Conclusions
Unintentional injuries were prevalent among people with SCI. After controlling for
injury and demographic characteristics, multiple risk behaviors were related to the
odds of unintentional injuries. Intervention studies are needed to address modifiable
behaviors that may reduce the risk of injury.
Keywords
List of abbreviations:
OR (odds ratio), 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
- National Hospital Ambulatory Medical Care Survey: 2015 emergency department summary tables.U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Health Statistics, Washington (DC)2015
- Deaths: final data for 2016.U.S. Department of Health and Human Services, Centers for Disease Control and Prevention; National Center for Health Statistics; National Vital Statistics System, Washington (DC)2018
- Spinal cord injury facts and figures at a glance.University of Alabama, Birmingham2019
- Risk for subsequent injuries after spinal cord injury: a 10-year longitudinal analysis.Arch Phys Med Rehabil. 2010; 91: 1741-1746
- Injuries and falls in an aging cohort with spinal cord injury: SCI Aging Study.Top Spinal Cord Inj Rehabil. 2015; 21: 201-207
- Factors associated with risk for subsequent injuries after traumatic spinal cord injury.Arch Phys Med Rehabil. 2004; 85: 1503-1508
Grant D. Seniors' falls—an emerging public health crisis. 2015. Available at: https://www.veterans.gc.ca/eng/resources/health/promotion/fallsp/senfalls. Accessed April 21, 2019.
- Falls after spinal cord injury: a systematic review and meta-analysis of incidence proportion and contributing factors.Spinal Cord. 2019; 57: 526-539
- Cause of death for patients with spinal cord injuries.Arch Intern Med. 1989; 149: 1761-1766
- Mortality, morbidity, and psychosocial outcomes of persons spinal cord injured more than 20 years ago.Paraplegia. 1992; 30: 617-630
- Annual Statistical Report–Complete Public Version.National Spinal Cord Injury Statistical Center, University of Alabama at Birmingham, Birmingham2016
- Health factors and spinal cord injury: a prospective study of risk of cause-specific mortality.Spinal Cord. 2019; 57: 594-602
- Personality, high-risk behaviors, and elevated risk of unintentional deaths related to drug poisoning among individuals with spinal cord injury.Arch Phys Med Rehabil. 2018; 99: 1941-1948
- Ambulation and complications related to assistive devices after spinal cord injury.J Spinal Cord Med. 2013; 36: 652-659
- Wheelchair-related falls in veterans with spinal cord injury residing in the community: a prospective cohort study.Arch Phys Med Rehabil. 2010; 91: 1166-1173
- Risk of fall-related injuries among ambulatory participants with spinal cord injury.Top Spinal Cord Inj Rehabil. 2013; 19: 259-266
- Validation of the Alcohol, Smoking And Substance Involvement Screening Test (ASSIST).Addiction. 2008; 103: 1039-1047
- The Alcohol Smoking and Substance Involvement Screening Test (ASSIST): manual for use in primary care.(Available at:) (Accessed October 24, 2019)
- Pain medication misuse among participants with spinal cord injury.Spinal Cord. 2015; 53: 630-635
- Factors associated with recurrent falls in individuals with traumatic spinal cord injury: a multicenter study.Arch Phys Med Rehabil. 2016; 97: 1908-1916
- Comparison of rates of hospitalization and emergency department visits using self-report and South Carolina administrative billing data among a population-based cohort with spinal cord injury.Arch Phys Med Rehabil. 2016; 97: 1481-1486
Article info
Publication history
Published online: October 10, 2019
Footnotes
Supported by the U.S. Department of Health and Human Services, Administration for Community Living (grant no. 90RT5003) and the South Carolina Spinal Cord Injury Research Fund (SCSCIRF) (grant no. 2017 SI-02). However, those contents do not necessarily represent the policy of the Department of Health and Human Services or the SCSCIRF, and you should not assume endorsement by the Federal Government or the state of South Carolina.
Identification
Copyright
© 2019 by the American Congress of Rehabilitation Medicine
