Health conditions: impact on function, health-related quality of life, and life satisfaction following traumatic spinal cord injury. A prospective observational registry cohort study

Publication date: Available online 19 July 2017
Source:Archives of Physical Medicine and Rehabilitation
Author(s): Carly S. Rivers, Nader Fallah, Vanessa K. Noonan, David GT. Whitehurst, Carolyn Schwartz, Joel Finkelstein, B. Catharine Craven, Karen Ethans, Colleen O'Connell, Catherine Truchon, Chester Ho, A. Gary Linassi, Christine Short, Eve Tsai, Brian Drew, Henry Ahn, Marcel F. Dvorak, Jérôme Paquet, Michael G. Fehlings, Luc Noreau
ObjectiveTo analyze relationships among injury, demographic and environmental factors on function, HRQoL and life satisfaction in individuals with traumatic SCI.Designprospective observational registry cohort studySetting31 acute and rehabilitation SCI centresParticipantsParticipants (N=340) from the Rick Hansen Spinal Cord Injury Registry (RHSCIR) who were prospectively recruited from 2004-2014 were included. The model cohort included 340 participants: 79.1% were male; mean age was 41.6 (±17.3SD); and 34.7% were motor/sensory complete (AIS A).InterventionsnoneMain Outcome MeasuresPath analysis was used to determine relationships among SCI severity [ASIA Impairment Score (AIS) and anatomical level (cervical/thoracolumbar)], age at injury, education, number of HCs, functional independence [Functional Independence Measure (FIM) motor score], HRQoL [Short Form-36V2 physical (PCS) and mental (MCS) component scores], and life satisfaction [Life Satisfaction-11 (LiSat-11)]. The analysis was conducted using Mplus version 7.1; model fit was assessed using recommended published indices.ResultsGood model fit was supported by all indices, indicating the model results closely matched the RHSCIR data. Higher age, higher severity injuries, cervical injuries, and more HCs negatively affected FIM motor, while employment had a positive effect. Higher age, less education, more severe injuries (AIS A-C), and more HCs negatively correlated with PCS (worse physical health). More HCs were negatively correlated with a lower MCS (worse mental health), however were positively associated with reduced function. Being married and higher function positively affected Lisat-11, but more HCs had a negative effect.ConclusionsComplex interactions and enduring impacts of HCs following SCI have a negative impact on function, HRQoL and life satisfaction. Modeling relationships among these types of concepts will inform clinicians how to positively impact outcomes following SCI; for example, development of screening tools and protocols for managing individuals with traumatic SCI who have multiple HCs.



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