People with traumatic spinal cord injuries at higher risk of developing chronic health problems

A new study by investigators from Mass General Brigham shows that patients with traumatic spinal cord injuries (TSCI) are at a higher risk of developing a myriad of chronic health problems, regardless of age, location of the injury and prior health status. Their results are published in JAMA Network Open.

The journey doesn't end when patients with traumatic spinal cord injuries leave the hospital or rehab. Programs should be implemented to identify patients at risk so that we can better manage their chronic care and address health issues that put patients at higher risk of death."

Saef Izzy, MD, FAAN, FNCS, corresponding author, neurologist, Department of Neurology at Mass General Brigham

Izzy reported that patients with TSCI were returning to the clinics with conditions such as hypertension, stroke, depression and diabetes, but it was unclear how common these conditions were among people with TSCI. While more immediate complications from TSCI-such as difficulty breathing, uncontrolled blood pressure, and heart rate problems-are well known few studies have looked at long-term health consequences for these patients.

With this in mind, researchers evaluated the long-term risk of cardiovascular, endocrine, neurologic, and psychiatric conditions in patients with TSCI, comparing rates to a control group of people who had not sustained this type of injury. Using data from Mass General Brigham and the University of California (UC) Health System, the researchers analyzed hospital-based registries from January 1996 to January 2024. The study included 1,038 patients with TSCI from Mass General Brigham and 1,711 patients with TSCI from UC. Over a follow-up period of up to 20 years, the researchers documented the incidence of chronic conditions and death in the patient group. These data were used to compare outcomes with matched control subjects without spinal cord injury.

Compared with controls, patients with a history of TSCI had significantly higher risk of high blood pressure, high cholesterol, stroke, and diabetes, along with other neurologic and psychiatric conditions. TSCI was associated with an increased risk of death, even in previously healthy patients.

This study relied on established medical codes to identify patient conditions. While there is a strong correlation between codes and new diagnoses, the authors note that they excluded patients with pre-existing conditions, which means their results may be more applicable to individuals who were healthier at the beginning of the study period. This could mean that the results underestimate how common chronic conditions are among patients who have had a TSCI.

"These findings highlight the need for proactive and multidisciplinary long-term care strategies," Izzy said. "Future studies are needed to identify effective interventions to reduce the burden of chronic disease among patients who have had a TSCI."