Abstract Details

Title Electrocardiogram Abnormalities within the First 72 Hours Following Acute Traumatic Spinal Cord Injury

Topic Critical Care/Emergency Neurology/Trauma

Presentation(s) P05 - (-)

Poster/Presentation
Number 201

Objective

Background BACKGROUND: Orthostatic hypotension, autonomic dysreflexia, and cardiac arrhythmias have been reported among individuals in the chronic stage after severe SCI at T6 or above. While those cardiovascular abnormalities are relatively well recognized in the chronic stage after SCI, little is known on this issue during the early stage post-SCI.

Design/Methods DESIGN/METHODS: This retrospective cohort study included all consecutive cases of spine trauma admitted to the Toronto Western Hospital from January/1998 to June/2007 that have had an ECG within the first 72 hours post-trauma. Individuals with history of prior cardiac arrhythmia were excluded. ECGs were read by two cardiologists who were blinded to the patients' clinical information. The cases were divided into four groups: (I) patients with complete motor SCI at T6 or above; (II) patients with incomplete SCI at T6 or above; (III) patients with spine trauma at T6 or above but no/minor SCI; (IV) patients with SCI below T6 level. Data were analysed using ANOVA and chi-square test.

Results RESULTS: There were 69 men and 20 women with mean age of 53.8 years (16-88 years). All groups were comparable regarding age, sex, pre-existing comorbidities, and cause of SCI. There were no significant differences among the groups regarding predominant rhythm, PR interval, atrial-ventricular conduction, ventricular rate, QRS axis, and intraventricular conduction abnormalities (p=0.341). Nonetheless, patients in Group I (n=29) had longer RR interval (p=0.016), longer QTc (p=0.025) and more prolonged duration of the longest QRS (p=0.017) in comparison with the other groups.

Conclusions CONCLUSIONS: Our results indicate that electrocardiogram abnormalities are seen within the first 72 hours following acute, severe (motor complete), cervical or high-thoracicSCI. Those may represent early manifestations of autonomic dysfunction due to disruption of descending cardiovascular pathways in individuals with severe SCI at T6 or above.

Authors/Disclosures
Julio C. Furlan, MD, PhD, MBA, MSc, FAAN (Lyndhurst Centre, Toronto Rehabilitation Institute; University of Toronto) PRESENTER	The institution of Dr. Furlan has received research support from Wings for Life Spinal Cord Research Foundation. The institution of Dr. Furlan has received research support from Craig H Neilsen Foundation. The institution of Dr. Furlan has received research support from Ontario Neurotrauma Foundation. The institution of Dr. Furlan has received research support from Cervical Spine Research Society. The institution of Dr. Furlan has received research support from J P Bickell Foundation. The institution of Dr. Furlan has received research support from Praxis Spinal Cord Institute. The institution of Dr. Furlan has received research support from Cervical Spine Research Society. The institution of Dr. Furlan has received research support from CRANIA. The institution of Dr. Furlan has received research support from Craig H Neilsen Foundation. The institution of Dr. Furlan has received research support from Cervical Spine Research Society. The institution of Dr. Furlan has received research support from Cervical Spine Research Society. The institution of Dr. Furlan has received research support from Tanenbaum Institute for Science in Sport. .
	No disclosure on file
	No disclosure on file
	No disclosure on file

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