Risk for subsequent injuries after spinal cord injury: a 10-year longitudinal analysis.

OBJECTIVES

To identify (1) the annual incidence of subsequent injury and injury-related hospitalizations in persons with preexisting spinal cord injury (SCI) and (2) risk and protective behaviors associated with differential risk for injury.

DESIGN

Longitudinal mailed survey. Participants were enrolled in 1997 to 1998, with a follow-up conducted 10 years later.

SETTING

Data were collected from participants identified from a specialty hospital and were analyzed at a medical university in the Southeastern United States.

PARTICIPANTS

Participants (N=1386) during the baseline enrollment, 821 of whom also participated in the 10-year follow-up. Inclusion criteria were (1) traumatic SCI with residual impairment, (2) nonsurgical onset, (3) aged 18 years or older, and (4) a minimum of 12 months post-SCI.

INTERVENTIONS

Not applicable.

MAIN OUTCOME MEASURES

Number of injuries severe enough to require treatment in a clinic, emergency department, or hospital in the 12 months before the survey and number of injury-related hospitalizations. Predictor variables included selected items from the Behavioral Risk Factor Surveillance System, the Zuckerman-Kuhlman Personality Questionnaire, and prescription medication use.

RESULTS

More than 23% of participants reported at least 1 injury within the past year, an increase from that reported 10 years earlier by the same participants (19%), and 7% reported at least 1 injury-related hospitalization. Those who reported a subsequent injury during the preliminary baseline data collection were about twice as likely to report at least 1 injury 10 years later. Binge drinking, psychotropic prescription medication use, and several personality characteristics also were related to injuries and/or injury-related hospitalization.

CONCLUSIONS

Risk for injury continues to be a significant concern in the years and decades after SCI onset. Behavioral and personality factors hold the key to prevention.