College of Health Professions, Medical University of South Carolina, Charleston, South Carolina.
Top Spinal Cord Inj Rehabil. 2020;26(4):283-289. doi: 10.46292/sci20-00020. Epub 2021 Jan 20.
Secondary health conditions (SHC) are physical and mental health conditions that are causally related to disabilities. Studies have found that SHC increase risk of negative health outcomes among people with traumatic spinal cord injury (TSCI). However, little has been done to assess the association of SHC with the risk of chronic health conditions (CHC) after TSCI.
To identify the prevalence of CHC in adults with TSCI, changes in CHC at follow-up, and the associations of baseline SHC with future CHC.
Participants included 501 adults with TSCI of at least 1-year duration, identified through a population-based surveillance system. Baseline and follow-up self-report assessments were completed. We measured seven SHC: fatigue, spasticity, pain, pressure ulcers, subsequent injury, fracture, and anxiety disorder, and measured seven CHC: diabetes, heart attack, coronary artery disease, stroke, cancer, hypertension, and high blood cholesterol. Control variables included gender, race/ethnicity, age at injury, years post injury, injury severity, smoking status, binge drinking, and taking prescription medication. We implemented a Poisson regression model for the multivariate analyses.
The total number of CHC, the percentage of participants having at least one CHC, and prevalence of three individual CHC (diabetes, cancer, and high cholesterol) increased from baseline to follow-up. After controlling for demographic, injury characteristics, and behavioral factors, pain interference and anxiety disorder at baseline were associated with the total number of CHC at follow-up.
CHC are common among adults with TSCI and increase significantly over time. Pain and anxiety disorders appear to be risk factors for future CHC.
继发健康状况（SHC）是指与残疾有因果关系的身体和心理健康状况。研究发现，SHC 会增加创伤性脊髓损伤（TSCI）患者负面健康结果的风险。然而，对于评估 SHC 与 TSCI 后慢性健康状况（CHC）的风险之间的关联，所做的工作甚少。
确定至少有 1 年病程的 TSCI 成年人中 CHC 的患病率，随访时 CHC 的变化，以及基线 SHC 与未来 CHC 的关联。
参与者包括通过人群监测系统确定的 501 名至少有 1 年病程的 TSCI 成年人。完成了基线和随访的自我报告评估。我们测量了七种 SHC：疲劳、痉挛、疼痛、压疮、继发损伤、骨折和焦虑障碍，并测量了七种 CHC：糖尿病、心脏病发作、冠状动脉疾病、中风、癌症、高血压和高胆固醇血症。控制变量包括性别、种族/民族、损伤时年龄、损伤后年限、损伤严重程度、吸烟状况、狂饮和服用处方药物。我们对多变量分析实施了泊松回归模型。
从基线到随访，CHC 的总数、至少有一种 CHC 的参与者百分比以及三种个体 CHC（糖尿病、癌症和高胆固醇血症）的患病率均有所增加。在控制人口统计学、损伤特征和行为因素后，基线时的疼痛干扰和焦虑障碍与随访时的总 CHC 相关。
CHC 在 TSCI 成年人中很常见，且随着时间的推移显著增加。疼痛和焦虑障碍似乎是未来 CHC 的危险因素。
