Hitzig Sander L, Tonack Mark, Campbell Kent A, McGillivray Colleen F, Boschen Kathryn A, Richards Kieva, Craven B Catharine
Lyndhurst Centre, Toronto Rehabilitation Institute, Toronto, Canada.
Am J Phys Med Rehabil. 2008 Jul;87(7):545-55. doi: 10.1097/PHM.0b013e31817c16d6.
This study describes self-reported incidence of secondary health complications (SHCs) and their associations with age, years postinjury (YPI), and impairment among a Canadian spinal cord-injured (SCI) cohort.
Cross-sectional telephone survey methods were used to collect data on (1) sociodemographics, (2) impairment, (3) health status, and (4) self-reported SHCs on 781 adults >or=1 yr post-SCI living in Ontario, Canada.
Logistic regression analyses were used to determine associations between self-reported incidences of SHCs with the following covariates: (1) age, (2) YPI, and (3) impairment. The odds ratios for cardiac complications, high blood pressure (HBP), and respiratory complications increased per year with age, whereas autonomic dysreflexia (AD), bladder infections, heterotopic ossification, psychological distress, and drug addiction decreased. The odds ratios for pressure ulcers, AD, and heterotopic ossification increased per YPI, whereas HBP, bowel problems, psychological distress, and depression decreased. Complete injuries were associated with bladder infections, pressure ulcers, and AD. Paraplegia was associated with HBP and bowel problems, and tetraplegia was associated with AD.
The findings provide some clarification on factors associated with the occurrence of SHCs after SCI and are useful for informing health-promotion planners, clinicians, and stakeholders regarding the odds of SHCs with aging or among specific impairment groups.
本研究描述了加拿大脊髓损伤(SCI)队列中自我报告的继发性健康并发症(SHC)的发生率及其与年龄、受伤后年限(YPI)和损伤程度之间的关联。
采用横断面电话调查方法,收集了加拿大安大略省781名SCI后1年及以上的成年人的以下数据:(1)社会人口统计学信息;(2)损伤程度;(3)健康状况;(4)自我报告的SHC。
采用逻辑回归分析来确定自我报告的SHC发生率与以下协变量之间的关联:(1)年龄;(2)YPI;(3)损伤程度。心脏并发症、高血压(HBP)和呼吸并发症的比值比随年龄增长而增加,而自主神经反射异常(AD)、膀胱感染、异位骨化、心理困扰和药物成瘾则下降。压疮、AD和异位骨化的比值比随YPI增加,而HBP、肠道问题、心理困扰和抑郁则下降。完全性损伤与膀胱感染、压疮和AD相关。截瘫与HBP和肠道问题相关,四肢瘫与AD相关。
这些发现为SCI后SHC发生的相关因素提供了一些明确信息,有助于健康促进规划者、临床医生和利益相关者了解衰老或特定损伤群体中SHC的发生几率。