Secondary health conditions and disability among people with spinal cord injury: A prospective cohort study

Abstract

<b>Objective:</b> To examine how secondary health conditions (SHCs) that develop early after a spinal cord injury (SCI) are related to disability over time.<b>Design:</b> Prospective cohort study.<b>Setting:</b> Two spinal units in New Zealand (Burwood Spinal Unit and Auckland Spinal Rehabilitation Unit).<b>Participants:</b> Between 2007 and 2009, 91 people participated in three telephone interviews approximately 6, 18, and 30 months after the occurrence of a SCI.<b>Outcome measures</b>: SHCs were measured using 14 items derived from the Secondary Complications Survey. Disability was measured using the 12-item World Health Organization Disability Assessment Schedule 2.0. Linear regression analyses were performed to investigate associations between SHCs at 6 months and disability at each assessment point.<b>Results:</b> The most prevalent SHCs were leg spasms, constipation, back pain, pain below the level of SCI, and shoulder pain. Constipation, urinary tract infection, and headaches at 6 months post-SCI were associated with significantly higher levels of disability at each subsequent follow-up, independent of age, sex and SCI impairment. Back pain, and pain below the SCI, at 6 months were associated with significantly greater disability at 18 months, and difficulty coughing at 6 months was associated with significantly greater disability at 30 months.<b>Conclusion:</b> The experience of specific SHCs in the first 6 months after an SCI is related to greater long-term disability. In order to reduce the disability burden of people with SCI, efforts should be directed toward early prevention of these SHCs.