BACKGROUND: Previous studies have noted similar outcomes between vascular-related spinal cord injury (VR-SCI) and those with traumatic SCI (T-SCI), despite significant difference in their demographics and clinical presentation (age, level of injury (LOI), and degree of incompleteness). OBJECTIVES: To review demographic and clinical presentation of VR-SCI and to compare outcomes with a matched group with T-SCI. Design Analysis of 10-year prospective data collection including 30 consecutive patients admitted to an SCI rehabilitation unit with VR-SCI and comparison with 573 patients with T-SCI. Outcomes were further analyzed comparing VR-SCI to T-SCI (n=30), matched for age, LOI, and ASIA (American Spinal Injury Association) Impairment Scale (AIS). SETTING: A level 1 tertiary university trauma center. MAIN OUTCOME MEASURES: Functional independence measure (FIM) score changes from admission to discharge. Secondary outcome measures included admission and discharge FIM scores, FIM efficiency, rehabilitation length of stay (LOS), and discharge disposition. RESULTS: Overall, individuals with VR-SCI were more likely (P<0.0001) to be older (mean age 57.2 vs. 40.0 years) and have paraplegia (87 vs. 48%) than those with T-SCI. Common etiologies for VR-SCI were post-surgical complication (43%), arteriovenous malformation (17%), aortic dissection (13%), and systemic hypotension (13%). Common region of injury and AIS classification in VR-SCI was thoracic (73%) and AIS C (33%). Common SCI-related complications in VR-SCI included neurogenic bowel/bladder (93%), urinary tract infection (73%), pain (67%), pressure ulcers (47%), and spasticity (20%). Matched-group outcome comparisons did not reveal significant differences in FIM change, FIM efficiency, LOS, or disposition between VR-SCI and T-SCI. CONCLUSION: VR-SCI leads to significant disability and is associated with common secondary SCI complications as well as medical co-morbidities. This study notes differing demographic and injury characteristics between VR-SCI and T-SCI groups. However, when matched for these differences, rehabilitation functional outcomes were not significantly different between the two groups.
BACKGROUND: Previous studies have noted similar outcomes between vascular-related spinal cord injury (VR-SCI) and those with traumatic SCI (T-SCI), despite significant difference in their demographics and clinical presentation (age, level of injury (LOI), and degree of incompleteness). OBJECTIVES: To review demographic and clinical presentation of VR-SCI and to compare outcomes with a matched group with T-SCI. Design Analysis of 10-year prospective data collection including 30 consecutive patients admitted to an SCI rehabilitation unit with VR-SCI and comparison with 573 patients with T-SCI. Outcomes were further analyzed comparing VR-SCI to T-SCI (n=30), matched for age, LOI, and ASIA (American Spinal Injury Association) Impairment Scale (AIS). SETTING: A level 1 tertiary university trauma center. MAIN OUTCOME MEASURES: Functional independence measure (FIM) score changes from admission to discharge. Secondary outcome measures included admission and discharge FIM scores, FIM efficiency, rehabilitation length of stay (LOS), and discharge disposition. RESULTS: Overall, individuals with VR-SCI were more likely (P<0.0001) to be older (mean age 57.2 vs. 40.0 years) and have paraplegia (87 vs. 48%) than those with T-SCI. Common etiologies for VR-SCI were post-surgical complication (43%), arteriovenous malformation (17%), aortic dissection (13%), and systemic hypotension (13%). Common region of injury and AIS classification in VR-SCI was thoracic (73%) and AIS C (33%). Common SCI-related complications in VR-SCI included neurogenic bowel/bladder (93%), urinary tract infection (73%), pain (67%), pressure ulcers (47%), and spasticity (20%). Matched-group outcome comparisons did not reveal significant differences in FIM change, FIM efficiency, LOS, or disposition between VR-SCI and T-SCI. CONCLUSION: VR-SCI leads to significant disability and is associated with common secondary SCI complications as well as medical co-morbidities. This study notes differing demographic and injury characteristics between VR-SCI and T-SCI groups. However, when matched for these differences, rehabilitation functional outcomes were not significantly different between the two groups.
Authors: C Masson; J P Pruvo; J F Meder; C Cordonnier; E Touzé; V De La Sayette; M Giroud; J L Mas; D Leys Journal: J Neurol Neurosurg Psychiatry Date: 2004-10 Impact factor: 10.154
Authors: K Jellema; C C Tijssen; W J J van Rooij; M Sluzewski; P J Koudstaal; A Algra; J van Gijn Journal: Neurology Date: 2004-05-25 Impact factor: 9.910
Authors: Marie Hidle Gedde; Hanne Sether Lilleberg; Jörg Aßmus; Nils Erik Gilhus; Tiina Rekand Journal: J Spinal Cord Med Date: 2019-04-03 Impact factor: 1.985
Authors: Peter Wayne New; Inge Eriks-Hoogland; Giorgio Scivoletto; Ronald K Reeves; Andrea Townson; Ruth Marshall; Farooq A Rathore Journal: Top Spinal Cord Inj Rehabil Date: 2017