Factors associated with risk for subsequent injuries after traumatic spinal cord injury

Abstract

Objectives: To identify the annual incidence and risk factors for subsequent injury among subjects with preexisting spinal cord injury (SCI).

Design: Cross-sectional, mailed survey.

Setting: A specialty hospital in the southeastern United States.

Participants: Subjects (N=1328) with SCI participated in this study (response rate, 72%), each of whom met the following inclusion criteria: (1) traumatic SCI with residual impairment American Spinal Injury Association (ASIA) grades A through D, (2) nonsurgical onset, (3) age 18 years or older at the time of the study, and (4) a minimum of 12 months post-SCI.

Interventions: Not applicable.

Main outcome measures: A general health assessment survey was used that required participants to report the number of injuries that were severe enough to require treatment in a clinic, emergency department, or hospital in the past year, as well as whether any injury resulted in hospitalization. Risk measures included the Behavioral Risk Factor Surveillance System, CAGE, Zuckerman-Kuhlman Personality Questionnaire, Multidimensional Health Locus of Control scale, and prescription medication usage.

Results: Nineteen percent of participants reported at least 1 injury within the past year, with an annual incidence of.33 when considering those with multiple injuries. Twenty-seven percent of those with at least 1 injury reported 1 or more injury-related hospitalizations in the past year. Being younger; having an ASIA grade D injury; higher sensation-seeking scores; heavy drinking; and prescription medication use for pain, spasticity, depression, and sleep were associated with a greater likelihood of subsequent injuries.

Conclusions: Subsequent injuries impact nearly 20% of people with SCI annually; yet, this problem has received little attention in the literature. Further study is needed to identify the costs, severity, and circumstances surrounding injury to design prevention programs that target risk behaviors.