Complications following spinal cord injury: occurrence and risk factors in a longitudinal study during and after inpatient rehabilitation

Abstract

Objective: To assess the occurrence and risk factors for complications following spinal cord injury during and after inpatient rehabilitation.

Design: Multicentre longitudinal study.

Subjects: A total of 212 persons with a spinal cord injury admitted to specialized rehabilitation centres.

Methods: Assessments at the start of active rehabilitation (n=212), 3 months later (n=143), at discharge (n=191) and 1 year after discharge (n=143).

Results: Multi-level random coefficient analyses revealed that complications were common following spinal cord injury. Most subjects reported neurogenic and musculoskeletal pain, or had spasticity at each assessment. During the year after discharge, complications remained common: urinary tract infections and pressure sores affected 49% and 36% of the population, respectively. The degree of pain decreased, whereas the degree of spasticity increased significantly during inpatient rehabilitation. Overall, increased age, increased body mass index, traumatic lesion, tetraplegia, and complete lesion all increased the risk of complications.

Conclusion: Complications are common following spinal cord injury. They need specific attention after discharge from inpatient rehabilitation and within subpopulations.