Traumatic Spinal Cord Injury and Subsequent Risk of Developing Chronic Cardiovascular, Neurologic, Psychiatric, and...

Area of Science:

• Neurology
• Cardiology
• Endocrinology
• Public Health

Background:

• Acute complications of traumatic spinal cord injury (TSCI) are well-documented.
• Long-term systemic health consequences, especially in previously healthy individuals, remain poorly understood.

Purpose of the Study:

• To assess the long-term risks of neurologic, psychiatric, cardiovascular, and endocrine comorbidities following TSCI.
• To evaluate the association between TSCI and all-cause mortality compared to uninjured controls.

Main Methods:

• Retrospective cohort study utilizing longitudinal data from two large hospital registries (Mass General Brigham and UC Health System) from January 1996 to January 2024.
• Matched 3:1 ratio of uninjured controls to TSCI patients based on age, sex, and race.
• Analysis of International Classification of Diseases (ICD-9/10) codes for comorbidities and multivariable Cox and logistic regression models for outcome assessment.

Main Results:

• Patients with TSCI exhibited significantly higher risks of hypertension, hyperlipidemia, ischemic stroke, coronary artery disease, and diabetes compared to controls.
• Elevated risks for post-TSCI comorbidities were observed across all age groups, including younger adults (18-45 years).
• Specific conditions like post-injury hypertension, pituitary dysfunction, adrenal insufficiency, depression, substance misuse, seizures, and dementia were associated with increased mortality.

Conclusions:

• TSCI is associated with a substantial increase in long-term multisystem morbidity and mortality, even in individuals without prior health issues.
• Findings highlight the critical need for proactive, longitudinal, and multidisciplinary care strategies for TSCI survivors.
• Early and ongoing management is essential to mitigate complications and improve outcomes for this high-risk population.