Complications of Spinal Cord Injury Over the First Year After Discharge from Inpatient Rehabilitation

Publication date: Available online 20 January 2017
Source:Archives of Physical Medicine and Rehabilitation
Author(s): Michael D. Stillman, Jason Barber, Steve Burns, Steve Williams, Jeanne M. Hoffman
ObjectivesTo describe the prevalence and cumulative incidence (CI) of secondary complications of spinal cord injury (SCI) in the first year after discharge from inpatient rehabilitation (IR). To evaluate potential associations between risk of complications and socio-demographic and injury-specific factors.DesignSecondary analysis of data collected for a single-site, single-blind, randomized controlled trial comparing telephone follow up to usual care.SettingTwo inpatient rehabilitation units comprising the Northwest Regional SCI System in Seattle, Washington.ParticipantsAdults ages 18 or over (n=169) within one year of discharge from IR following SCI.InterventionsNot applicable.Main Outcome MeasuresSelf-report of 10 secondary complications of SCI.ResultsParticipants experienced a mean of 4.7 complications over 12 months. The most frequently reported complications were urinary tract infection (UTI), autonomic dysreflexia (AD), and pressure ulcers with CIs of 62%, 43%, and 41%, respectively. Bone and soft tissue injuries (CI 35%) and bowel problems including "impaction or severe constipation" (CI 33%) were also common. Cumulative incidences of AD, decubitus ulcers, UTI, and problems with bladder were greater in participants with higher level and more complete injuries, and some recurrent complications were common. Age at injury and impairment level significantly affected rates of complications, and subjects developed an average of 2.33 distinct complications during the study period.ConclusionsPeople with SCI are at high-risk for a number of secondary complications over the first year after discharge from IR. While these data offer some insight into who with SCI is at highest risk for first time and recurrent complications, further study is needed to refine this understanding and to develop effective educational and prevention strategies.



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