scholarly journals Risk factors for mortality after spinal cord injury in the USA

Spinal Cord ◽  
2013 ◽  
Vol 51 (5) ◽  
pp. 413-418 ◽  
Author(s):  
Y Cao ◽  
J S Krause ◽  
N DiPiro
Keyword(s):  
Risk Factors ◽  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Cord Injury ◽  
The Usa

scholarly journals Development of Predictive Informatics Tool Using Electronic Health Records to Inform Personalized Evidence-Based Pressure Injury Management for Veterans with Spinal Cord Injury

2021 ◽  
Vol 186 (Supplement_1) ◽  
pp. 651-658
Author(s):  
Kath M Bogie ◽  
Steven K Roggenkamp ◽  
Ningzhou Zeng ◽  
Jacinta M Seton ◽  
Katelyn R Schwartz ◽  
...  
Keyword(s):  
Risk Factors ◽  
Health Care ◽  
Spinal Cord ◽  
Spinal Cord Injury ◽  
User Interface ◽  
Veterans Health Administration ◽  
Study Cohort ◽  
Veterans Health ◽  
Health Administration ◽  
Cord Injury

ABSTRACT Background Pressure injuries (PrI) are serious complications for many with spinal cord injury (SCI), significantly burdening health care systems, in particular the Veterans Health Administration. Clinical practice guidelines (CPG) provide recommendations. However, many risk factors span multiple domains. Effective prioritization of CPG recommendations has been identified as a need. Bioinformatics facilitates clinical decision support for complex challenges. The Veteran’s Administration Informatics and Computing Infrastructure provides access to electronic health record (EHR) data for all Veterans Health Administration health care encounters. The overall study objective was to expand our prototype structural model of environmental, social, and clinical factors and develop the foundation for resource which will provide weighted systemic insight into PrI risk in veterans with SCI. Methods The SCI PrI Resource (SCI-PIR) includes three integrated modules: (1) the SCIPUDSphere multidomain database of veterans’ EHR data extracted from October 2010 to September 2015 for ICD-9-CM coding consistency together with tissue health profiles, (2) the Spinal Cord Injury Pressure Ulcer and Deep Tissue Injury Ontology (SCIPUDO) developed from the cohort’s free text clinical note (Text Integration Utility) notes, and (3) the clinical user interface for direct SCI-PIR query. Results The SCI-PIR contains relevant EHR data for a study cohort of 36,626 veterans with SCI, representing 10% to 14% of the U.S. population with SCI. Extracted datasets include SCI diagnostics, demographics, comorbidities, rurality, medications, and laboratory tests. Many terminology variations for non-coded input data were found. SCIPUDO facilitates robust information extraction from over six million Text Integration Utility notes annually for the study cohort. Visual widgets in the clinical user interface can be directly populated with SCIPUDO terms, allowing patient-specific query construction. Conclusion The SCI-PIR contains valuable clinical data based on CPG-identified risk factors, providing a basis for personalized PrI risk management following SCI. Understanding the relative impact of risk factors supports PrI management for veterans with SCI. Personalized interactive programs can enhance best practices by decreasing both initial PrI formation and readmission rates due to PrI recurrence for veterans with SCI.

Abstract P313: De-Conditioning Adversely Affects Subclinical Atherosclerosis in a Unique Cohort of Spinal Cord Injury

Circulation ◽  
2012 ◽  
Vol 125 (suppl_10) ◽  
Author(s):  
Yaga Szlachcic ◽  
Rodney H Adkins ◽  
Jamie C Reiter ◽  
Yanjie Li ◽  
Howard N Hodis
Keyword(s):  
Risk Factors ◽  
Spinal Cord ◽  
Heart Rate ◽  
Spinal Cord Injury ◽  
Subclinical Atherosclerosis ◽  
Cvd Risk Factors ◽  
Peak Heart Rate ◽  
Cvd Risk ◽  
Cord Injury ◽  
Aerobic Conditioning

Introduction: Physical activity is presumed to improve cardiovascular disease (CVD), of which carotid artery intima-media thickness (CIMT) is a common indicator. Individuals with spinal cord injury (SCI) have limited mobility and therefore an expected increased risk for CVD. The purpose of this study was to determine which CVD risk factors predict CIMT among women with SCI, with the ultimate goal of targeting therapy to improve CVD in this population. Methods: One hundred twenty-two women with SCI who attended an outpatient SCI clinic and met inclusion and exclusion criteria participated in this study. SCI was categorized into 1 of 4 categories: complete tetraplegia, incomplete tetraplegia, complete paraplegia, and incomplete paraplegia. Maximum heart rate and VO2 max were obtained using bicycle ergometry with ventilatory gas exchange and continuous electrocardiogram. Hierarchical regression was used to predict CIMT, with the first block including demographic variables (age, race, smoking status) and the second block including physiologic variables (total cholesterol, heart rate, VO2 max, BMI, fasting serum glucose, hemoglobin A1c, and blood pressure). Results: Similar findings were observed for left and right CIMT, therefore only results from right CIMT are reported. The overall model was significant, F(16,46)=8.53, p=.000. Adjusted R square was .54 for the first block of variables and increased significantly (p=.006) to .66 when the second block of variables was added. Significant predictors at alpha=.05 included age (beta=.51, t=4.79, p=.000) and max/peak heart rate (beta=−.336, t=−2.39, p=.02). At alpha=.10, A1c was significant (beta=.187, t=1.99, p=.053). Conclusions: Although low aerobic conditioning is a purported CVD risk factor, quantitative measurements of such lack a demonstrable relationship with subclinical atherosclerosis (CIMT), perhaps because of its reduced importance relative to other CVD risk factors in a mobile population. We found expected relationships with CIMT in our SCI population (i.e., age), however we also found a quantitative measure of aerobic conditioning (max/peak heart rate) to be associated with CIMT. Our data indicate that SCI individuals may bear a greater CVD burden from cardiac de-conditioning than the general population and that investigation of a cohort with mobility limitation may provide a unique opportunity to study the impact of physical conditioning on CVD risk.

Bacteremia In The Chronic Spinal Cord Injury Population: Risk Factors For Mortality

2003 ◽  
Vol 26 (3) ◽  
pp. 248-253 ◽  
Author(s):  
Barry Wall ◽  
Therese Mangold ◽  
Kim M. Huch ◽  
Cathy Corbett ◽  
Robert C. Cooke
Keyword(s):  
Risk Factors ◽  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Chronic Spinal Cord Injury ◽  
Cord Injury

scholarly journals COMPLICATIONS OF ACUTE TRAUMATIC SPINAL INJURIES IN SAINT PETERSBURG

2020 ◽  
Vol 6 (1) ◽  
pp. 33-42
Author(s):  
S. V. Lobzin ◽  
L. M. Mirzaeva
Keyword(s):  
Quality Of Life ◽  
Risk Factors ◽  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Vertebral Fractures ◽  
Length Of Hospital Stay ◽  
Respiratory Complications ◽  
Traumatic Injuries ◽  
Cord Injury

Almost every sailor during performing his job duties aboard receives injuries of varying severity, among which the most common are deck fractures, including compression vertebral fractures, as well as open and closed vertebral fractures with spinal cord injuries. Besides the recovery of disordered functions of the spinal cord, in cases of spinal cord injury, the fight against numerous neurological, infectious and somatic complications affecting the survival and quality of life of patients is still relevant.Objective: to study the incidence of complications of traumatic injuries of the spinal cord under initial hospitalization, their impact on the length of hospital stay, to identify and evaluate the role of risk factors in the development of complications.Materials and methods. A retrospective cohort study was conducted according to the archived case histories of patients hospitalized in neurosurgical hospitals in St. Petersburg. 311 cases of acute spinal cord injury in 2012–2016 were analyzed.Results: complications not directly related to spinal cord injury, such as bronchitis, pneumonia, bedsores, sepsis, thromboembolism, urinary tract infections, postoperative wound pyogenesis and others (damage to other organs and systems), were found in one third of patients (33,8%), in half of the cases there were multiple complications (2 or more), the most frequent — respiratory (23,5%) and pressure sores (10%). Complications significantly increased the length of hospital stay. The dependence of the frequency of complications on age, the level of spinal cord damage and the severity of the injury was revealed. Risk factors such as concomitant head injury and alcohol intoxication have been found. The revealed positive effect of corticosteroids on the regression of neurological deficit was not statistically confirmed. At the same time, there was a significant increase in the frequency of respiratory complications when using corticosteroids.Conclusion: Knowledge of the factors affecting the incidence of complications, optimization of their prevention and therapy will shorten the duration of hospitalization and improve the prognosis and quality of life of patients. The issue of use of corticosteroid therapy in the acute period of traumatic injuries of the spinal cord remains debatable. When choosing therapeutic tactics for managing patients with spinal trauma, it is necessary to take into account the risk of respiratory complications and carefully evaluate the ratio of benefits to harm. 

scholarly journals Risk factors for tracheostomy after traumatic cervical spinal cord injury

2019 ◽  
Vol 27 (3) ◽  
pp. 230949901986180
Author(s):  
Zhiping Mu ◽  
Zhengfeng Zhang
Keyword(s):  
Risk Factors ◽  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Logistic Regression ◽  
Cervical Spinal Cord ◽  
Neurological Impairment ◽  
Acute Stage ◽  
Cervical Spinal Cord Injury ◽  
Smoking History ◽  
Cord Injury

Objective: To determine the risk factors for the need of tracheostomy after cervical spinal cord injury (CSCI) at the acute stage. Methods: The authors retrospectively reviewed 294 patients with acute traumatic CSCI in Xinqiao Hospital between 2012 and 2016 and analyzed the factors postulated to increase the risk for tracheostomy, including patient’s age, neurological impairment scale grade and level, smoking history, combined injury, and surgical intervention. Logistic regression analysis was used to identify independent risk factor for the need of tracheostomy. Results: Of 294 patients, 52 patients received tracheostomy (17.7%). The factor identified by demographics and outcomes were smoking history, cause of injury, neurological impairment scale grade and level, and combined dislocation. A multiple logistic regression model demonstrated that age of 60 years older, combined facet dislocation, C4 level high, and the American Spinal Injury Association (ASIA) A and B scale were predictive of need for tracheostomy on 95% occasions. Conclusion: The high age of 60 years, combined facet dislocation, C4 level high, and ASIA A and B scale are indispensable to predict the need for tracheostomy in patients with CSCI at the acute stage.

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