Article

OBJECTIVES: To determine longitudinal changes in the occurrence of medical
complications in adults with pediatric-onset spinal cord injury (SCI). DESIGN:
Longitudinal study of long-term outcomes. SETTING: Community. PARTICIPANTS:
Individuals who had sustained an SCI before age 19, were 23 years of age or older
at initial interview, and followed annually between 1996 and 2011. They were
classified into four American Spinal Injury Association (ASIA) Impairment Scale
(AIS) severity groups: C1-4 AIS ABC, C5-8 AIS ABC, T1-S5 AIS ABC, AIS D. OUTCOME
MEASURES: Generalized estimating equation (GEE) models were formulated to obtain
the odds ratio (OR) of having a medical complication over time. RESULTS: A total
of 1793 interviews were conducted among 226 men and 125 women (86% Caucasian; age
at baseline, 26.7 +/- 3.6 years; time since injury at baseline, 12.9 +/- 5.2
years). Odds of complication occurrence over time varied among severity groups,
with increased ORs of severe urinary tract infection (1.05, confidence interval
(CI) 1.02-1.09), autonomic dysreflexia (AD) (1.09, CI 1.05-1.14), spasticity
(1.06, CI 1.01-1.11), pneumonia/respiratory failure (1.09, CI 1.03-1.16), and
hypertension/cardiac disease (1.07, CI 1.01-1.15) in the C1-4 ABC group; AD
(1.08, CI 1.04-1.13) and pneumonia/respiratory failure (1.09, CI 1.02-1.16) in
the C5-8 ABC group; and hypertension/cardiac disease (1.08, CI 1.02-1.14) in the
T1-S5 ABC group. Upper extremity joint pain had increased odds of occurrence in
all injury severity groups. CONCLUSION: The significantly increased odds of
having medical complications over time warrants awareness of risk factors and
implementation of preventive measures to avoid adverse consequences of
complications and to maintain independence in individuals with pediatric-onset
SCI.

Langue : ANGLAIS

Tiré à part : OUI