Characteristics and cardiometabolic profiles in patients with spinal cord injury in the UK

Cardiovascular disease (CVD) is the leading cause of mortality in individuals with spinal cord injury (SCI). This study examined patient characteristics, SCI-specific factors, and biochemical parameters associated with CVD risk.

A retrospective secondary analysis was conducted on 421 patients admitted between January and December 2017. Demographic, clinical, and biochemical data were recorded within 7 days of admission. CVD risk was estimated using the QRISK-2 score. Between-group differences were examined using Chi-square and Kruskal - Wallis tests. Logistic regression with multiple imputation was performed to identify predictors of CVD risk.

Most patients were male (73%), aged <65 years (74%), and had traumatic SCI (68%). Over half (56%) were at medium/high CVD risk. Common biochemical abnormalities included vitamin D deficiency/insufficiency (56%), hypoalbuminemia (46%), anemia (42%), elevated C-reactive protein (CRP) (48%), low creatinine (55%), overweight/obesity (49%), high cholesterol (40%), low high-density lipoprotein cholesterol (43%), and high cholesterol/HDL ratio (28%). Univariate regression identified higher creatinine (OR 1.02), CRP (OR 1.01), and hypoalbuminemia (OR 0.923) as independent predictors of increased CVD risk, alongside traditional factors (male sex, older age, high total cholesterol, low HDL, elevated cholesterol/HDL ratio). Multivariate analysis confirmed significant associations of serum albumin (negative) and creatinine (positive) with CVD risk. No significant associations were found with injury level, onset, or nutritional risk scores.

Patients with SCI often present at admission with high rates of CVD risk and biochemical abnormalities. A more systematic approach with clear clinical guidance for routine CVD risk assessment at admission is required, alongside tailored early interventions.