Poster (Clinical/Best Practice Implementation) ID 1969157

Abstract

This study examined the effects of concomitant TBI on injury epidemiology, management and outcomes of individuals with traumatic SCI. A propensity-score matched cohort study compared a SCI+TBI group (n=1018) with a SCI-only group (n=3687), which were matched on a 1:1 ratio by age, sex, severity and level of SCI, and Charlson Comorbidity Index. TBI was defined as a Glasgow coma score of <15 at admission. Both groups were compared regarding injury epidemiology (mechanism, ethnicity, GCS, other injuries), management (mechanical ventilation, traction, Methylprednisone, surgery, time to decompression), and post-SCI outcomes (length of stay [LOS], International Standards for Neurological Classification of SCI [ISNCSCI] motor subscore, Functional Independence Measure, discharge destination, spasticity and pain at discharge). Overall, being white (OR=5.332, p=0.0265) was associated with having TBI, while having other body injuries (OR=0.095, p=0.0065) was associated with the SCI-only group. Odds of dying in a hospital were 2.442 times larger for the TBI+SCI group. The TBI+SCI group had longer acute-care LOS. Both groups had similar rehabilitation LOS. Odds of being discharged to nursing homes/long-term care facilities were 1.949 times higher for TBI+SCI individuals. Concomitant TBI did not influence change in ISNCSCI motor subscore from initial admission to final discharge. Odds of individuals with pain was 1.52 times higher for the TBI+SCI group. Occurrence of spasticity was similar between the groups. This study highlights discrepancies between the TBI+SCI and SCI-only groups regarding injury epidemiology, survival, discharge disposition, and pain. Both groups experienced similar access to treatment services, motor recovery, and spasticity. These data were presented in the 2022 Annual Meeting of the American Neurological Association, which has a different attendance audience.