Abstract
Study design
Cross-sectional study.
Objectives
Determine how well common clinical assessments of level and completeness of injury are correlated with symptoms of autonomic blood pressure instability and secondary medical complications after spinal cord injury (SCI).
Setting
Academic medical center, United States.
Methods
Eighty-two individuals with (n = 48) and without (n = 34) SCI had symptoms of autonomic blood pressure instability quantified with the Autonomic Dysfunction Following SCI (ADFSCI) survey. Health histories quantified the secondary medical complications through number of urinary tract infections and hospitalizations in the past year, time to complete bowel program, and lifetime pressure injuries. Regression models were completed to identify strengths of associated correlations.
Results
ADFSCI scores were significantly higher in individuals with SCI than controls. Neurological level of injury and ASIA impairment scale were both minimally correlated to symptoms of autonomic blood pressure instability, accounting for only 11.5% of variability in regression models. Secondary medical complications had similar, minimal correlations to level and motor/sensory completeness of SCI (R2 = 0.07 and R2 = 0.03 respectively). Contrasting this, symptoms of blood pressure instability on ADFSCI far outperformed the common clinical motor/sensory bedside exam, with moderately strong correlations to the ranked number of secondary medical complications after SCI (R2 = 0.31).
Conclusion
Neurological level of injury and motor/sensory completeness provided limited insights into which individuals with SCI would have blood pressure instability or secondary medical complications. Interestingly, symptoms of blood pressure instability outperform the clinical motor/sensory bedside exam, with higher correlations to secondary medical complications after SCI.
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Data availability
The authors agree to make data available upon reasonable request to corresponding author.
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Funding
Data used for this study was derived from previous studies including K23HD102663 through NIH/NICHD and the Foundation for Physical Medicine & Rehabilitation. Further data was supported by pilot funding from the National Institutes of Health National Center of Neuromodulation for Rehabilitation, the National Center for Complementary and Integrative Health, the National Institute on Deafness and Other Communication Disorders, and the National Institute of Neurological Disorders and Stroke. NIH/NICHD Grant Number P2CHD086844 which was awarded to the Medical University of South Carolina. The contents are solely the responsibility of the authors and do not necessarily represent the official views of the NIH or NICHD.
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KB and RS both contributed substantially to the study design, data capture and aggregation, statistical analysis, and manuscript preparation.
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Burns, K., Solinsky, R. Autonomic impairment is not explained by neurological level of injury or motor-sensory completeness. Spinal Cord (2024). https://doi.org/10.1038/s41393-024-00994-7
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DOI: https://doi.org/10.1038/s41393-024-00994-7