Cardiometabolic risk profiling during spinal cord injury rehabilitation: A longitudinal analysis from Swiss Spinal Cord Injury cohort (SwiSCI).

Raguindin, Peter Francis; Stoyanov, Jivko; Eriks-Hoogland, Inge; Stucki, Gerold; Jordan, Xavier; Schubert, Martin; Franco, Oscar H; Muka, Taulant; Glisic, Marija (2023). Cardiometabolic risk profiling during spinal cord injury rehabilitation: A longitudinal analysis from Swiss Spinal Cord Injury cohort (SwiSCI). PM & R : the journal of injury, function, and rehabilitation, 15(6), pp. 715-730. Wiley 10.1002/pmrj.12857

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Early screening is important in individuals with spinal cord injury (SCI) as they were deemed high-risk for cardiometabolic diseases. Few studies explored changes in cardiometabolic risk profile in the early phase of the injury. Thus, it remains unclear how early the cardiometabolic status deteriorates after injury.


We determined the longitudinal changes in the cardiometabolic risk profile and examined the association between injury characteristics and cardiometabolic status in subacute SCI.


Multicenter Swiss Spinal Cord Injury Cohort.


Adults with traumatic SCI without history of cardiovascular disease or type 2 diabetes.


Blood pressure (BP), lipid profile, fasting glucose, waist circumference (WC), weight, body mass index (BMI) and Framingham risk score (FRS) were compared across time and according to the injury characteristics.


We analyzed the data of 258 individuals with traumatic SCI (110 tetraplegia and 148 paraplegia, 122 motor complete and 136 incomplete). The median age was 50 years (IQR 32-60), with 76.36% (n=197) of the population being male. The median rehabilitation duration was 5.5 months (IQR 3.2-7.1). At admission to rehabilitation, fully-adjusted linear regression models showed higher baseline weight (β 0.06, 95% CI 0.005, 0.11), systolic BP (β 0.05, 95% CI 0.008, 0.09), diastolic BP (β 0.05 95% CI 0.004, 0.10), and triglycerides (β 0.27 95% CI 0.13, 0.42) in paraplegia than tetraplegia. Systolic BP, diastolic BP, HDL-C were higher in incomplete than complete injury. In our main analysis, we observed an increase in cholesterol and HDL-C and lipid ratio when comparing the beginning and end of rehabilitation. Individuals with paraplegia had a higher increase in BMI than tetraplegia, while no differences in other cardiometabolic risk factors were detected when comparing motor incomplete and complete injury. Trajectories of each participant showed that the majority of individuals with SCI decreased FRS score at follow-up compared to baseline and no significant changes in prevalence of cardiometabolic syndrome were observed. At discharge, one-third of study participants were classified as moderate to high risk of CVD, 64% were overweight, and 39.45% had cardiometabolic syndrome.


We observed a modest improvement in lipid profile and FRS during the first inpatient rehabilitation hospitalization. Injury characteristics, such as level and completeness, were not associated with changes in cardiometabolic risk factors in the subacute phase of the injury. Despite this, a significant proportion of study participants remained at risk of cardiometabolic disease at discharge, suggesting that early cardiometabolic preventive strategies may be initiated as early as during the first inpatient rehabilitation hospitalization. This article is protected by copyright. All rights reserved.

Item Type:

Journal Article (Original Article)


04 Faculty of Medicine > Pre-clinic Human Medicine > Institute of Social and Preventive Medicine (ISPM)

Graduate School:

Graduate School for Health Sciences (GHS)

UniBE Contributor:

Raguindin, Peter Francis, Franco Duran, Oscar Horacio, Muka, Taulant, Glisic, Marija


600 Technology > 610 Medicine & health
300 Social sciences, sociology & anthropology > 360 Social problems & social services








Pubmed Import

Date Deposited:

02 Jun 2022 09:38

Last Modified:

20 Jul 2023 07:44

Publisher DOI:


PubMed ID:


Uncontrolled Keywords:

cardiovascular risk cardiovascular risk factors paraplegia spinal cord injury tetraplegia




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