Abstract Details

Title The Influence of Concomitant Traumatic Brain Injury (TBI) on the Survival, and Neurological and Functional Recovery after Traumatic Spinal Cord Injury (SCI): Analysis of a Cohort of 499 cases from the Third National Spinal Cord Injury Study.

Topic Neuro-rehabilitation

Presentation(s) Neuro-rehabilitation Posters (7:00 AM-5:00 PM)

Poster/Presentation
Number 008

Objective This study examined the potential effects of concomitant TBI on clinical, neurological and functional outcomes at 1 year following traumatic SCI.

Background Concomitant TBI is relatively common among individuals with traumatic SCI, but the potential effects of TBI on the outcomes post-SCI remain under-studied.

Design/Methods This retrospective cohort study included all individuals who were enrolled into the NASCIS-3. TBI was defined as a Glasgow coma score below 15 at admission. Individuals with dual diagnosis (SCI+TBI) were compared with the individuals with SCI alone regarding survival, and neurological and functional outcomes within the first year post-SCI. Survival was analyzed using Kaplan-Meier curve and log-rank test. Data were analyzed using multiple regression models adjusted for the major potential confounders.

Results There were 76 females and 423 males with mean age of 35.7 years (range: 14-92 years) who were grouped into individuals with SCI (n=413) and individuals with SCI+TBI (n=86; GCS from 10 to 14). Both groups were comparable regarding age (p=0.7101) and sex distribution (p=0.6207). However, the dual-diagnosis group had higher proportion of complete (p=0.0059) and cervical SCI (p=0.0031) and more often received 48-hour methylprednisolone treatment (p=0.0384) than SCI-only group. There was no significant difference between the groups regarding survival post-SCI (p=0.7676). Among the survivors, the dual-diagnosis group showed significantly lower neurological scores and functional scores at 1 year post-SCI than the SCI-only group. After adjusting for the major potential confounders, neurological outcomes (motor, sensory and pain scores) and functional outcome (total FIM score) at 1 year post-SCI were not significantly affected by the concomitant TBI.

Conclusions Individuals with TBI+SCI had more severe and cervical SCI that resulted in less favorable neurological and functional outcomes than individuals with SCI alone. Nevertheless, the coexistence of TBI and SCI did not appear to intrinsically affect their survival, and neurological and functional recovery within the first year after trauma.

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.

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