Volume 16, Issue 8 pp. 804-814

ORIGINAL ARTICLE—CME

Concomitant traumatic brain injury as a determinant of survival, and neurological and functional outcomes after traumatic spinal cord injury: A retrospective cohort study

Julio C. Furlan MD, LLB, MBA, MSc, PhD, FRCPC, FAAN,

Corresponding Author

Julio C. Furlan MD, LLB, MBA, MSc, PhD, FRCPC, FAAN

[email protected]

orcid.org/0000-0002-2038-0018

Lyndhurst Centre, Toronto Rehabilitation Institute, University Health Network, Toronto, Ontario, Canada

KITE Research Institute, University Health Network, Toronto, Ontario, Canada

Department of Medicine, Division of Physical Medicine and Rehabilitation, University of Toronto, Toronto, Ontario, Canada

Rehabilitation Sciences Institute, University of Toronto, Toronto, Ontario, Canada

Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada

Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada

Correspondence

Julio C. Furlan, 520 Sutherland Drive, Room 206J, Toronto, ON M4G 3V9, Canada.

Email: [email protected]

Search for more papers by this author

Julio C. Furlan MD, LLB, MBA, MSc, PhD, FRCPC, FAAN,

Corresponding Author

Julio C. Furlan MD, LLB, MBA, MSc, PhD, FRCPC, FAAN

[email protected]

orcid.org/0000-0002-2038-0018

Lyndhurst Centre, Toronto Rehabilitation Institute, University Health Network, Toronto, Ontario, Canada

KITE Research Institute, University Health Network, Toronto, Ontario, Canada

Department of Medicine, Division of Physical Medicine and Rehabilitation, University of Toronto, Toronto, Ontario, Canada

Rehabilitation Sciences Institute, University of Toronto, Toronto, Ontario, Canada

Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada

Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada

Correspondence

Julio C. Furlan, 520 Sutherland Drive, Room 206J, Toronto, ON M4G 3V9, Canada.

Email: [email protected]

Search for more papers by this author

First published: 27 December 2023

https://doi.org/10.1002/pmrj.13123

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Abstract

Background

Although concomitant traumatic brain injury (TBI) is not infrequently associated with spinal cord injury (SCI), there is relatively scarce information about the effects of concomitant TBI on outcomes after SCI.

Objective

To assess the impact of concomitant mild-to-moderate TBI on survival, and neurological and functional outcomes within the first year after acute traumatic SCI.

Design

Retrospective cohort study.

Setting

Acute spine trauma centers in the United States.

Participants

This study includes all individuals who were enrolled into the Third National Spinal Cord Injury Study (NASCIS-3). The study population was classified into SCI + TBI group and SCI-alone group. TBI was defined as a Glasgow Coma Scale score <15 on admission.

Intervention

Not applicable.

Main Outcome Measures

Both groups were compared regarding their survival and neurological outcomes (ie, NASCIS motor, sensory and pain scores) and functional outcome (ie, Functional Independence Measure score) within the first year following SCI. Data analyses were adjusted for major potential confounders.

Results

There were 413 individuals in the SCI-alone group and 86 individuals in the SCI + TBI group (17.2%). Both groups were comparable regarding gender distribution (p = .621). However, the SCI + TBI group was older (p < .001), had a higher proportion of complete (p = .006) and cervical SCI (p = .003), and had a higher blood alcohol level (p < .001) than the SCI-alone group. The SCI + TBI group did not significantly differ from the SCI-alone group regarding survival within the first year after SCI (p = .768). Among the survivors, concomitant mild-to-moderate TBI did not significantly affect neurological and functional outcomes at 1 year after SCI in the multiple regression analyses after adjusting for major potential confounders.

Conclusions

The results of this study suggest that concomitant mild-to-moderate TBI did not have a significant impact on survival, neurological recovery, and functional outcomes at 1 year after SCI, even though there were some epidemiological differences between SCI-alone and SCI + TBI groups.

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Volume16, Issue8

August 2024

Pages 804-814

Concomitant traumatic brain injury as a determinant of survival, and neurological and functional outcomes after traumatic spinal cord injury: A retrospective cohort study

Abstract

Background

Objective

Design

Setting

Participants

Intervention

Main Outcome Measures

Results

Conclusions

REFERENCES

References

Information

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Concomitant traumatic brain injury as a determinant of survival, and neurological and functional outcomes after traumatic spinal cord injury: A retrospective cohort study

Abstract

Background

Objective

Design

Setting

Participants

Intervention

Main Outcome Measures

Results

Conclusions

REFERENCES

References

Related

Information