The burden of cardiovascular risk in individuals with spinal cord injury (SCI) and its association with rehabilitation outcomes - Results from the Swiss SCI Cohort.

Raguindin, Peter Francis; Mueller, Gabi; Stoyanov, Jivko; Eriks-Hoogland, Inge; Jordan, Xavier; Stojic, Stevan; Hund-Georgiadis, Margret; Muka, Taulant; Stucki, Gerold; Glisic, Marija (2023). The burden of cardiovascular risk in individuals with spinal cord injury (SCI) and its association with rehabilitation outcomes - Results from the Swiss SCI Cohort. American journal of physical medicine & rehabilitation, 102(12), pp. 1043-1054. Lippincott Williams & Wilkins 10.1097/PHM.0000000000002276

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OBJECTIVES

To determine the cardiovascular risk burden rehabilitation discharge, and explore the association between recovery during rehabilitation and CVD-risk profile.

METHODS

We included adults without CVD history admitted for rehabilitation. We evaluated rehabilitation outcomes on admission and discharge. CVD-risk was assessed by Framingham risk score (FRS), high-density lipoprotein (HDL), and fasting glucose level.

RESULTS

We analyzed data from 706 participants (69.55% men) with median age of 53.5 years. The median time-since-injury was 14 days and the admission length was 5.2 months. Majority had paraplegia (53.26%), and motor incomplete injury (53.68%). One-third of the cohort had high cardiovascular risk profile pre-discharge. At discharge, poorer anthropometric measures were associated with higher FRS and lower HDL levels. Individuals with higher forced vital capacity (>2.72 L) and peak expiratory flow (>3.4 L/min) had 0.16 mmol/L and 0.14 mmol/L higher HDL compared to those with lower respiratory function, respectively. Individuals with higher mobility score (>12.5) and functional independence score (>74) had 0.21 mmol/L and 0.18 mmol/L higher HDL compared to those with lower scores.

CONCLUSION

There is high cardiometabolic syndrome burden and CVD-risk upon rehabilitation discharge. Higher respiratory function, mobility, and overall independence were associated with better CVD profile, although with study design limitations and short follow-up. Future studies should explore whether rehabilitation outcomes could be used to prioritize screening.

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