Abstract
PURPOSE OF STUDY: People who have a traumatic spinal cord injury (SCI) are at risk of concomitant traumatic brain injury (TBI). The incidence and consequences for such ‘dual diagnosis’ (DD) patients are under-investigated in the literature. The project aimed to identify: 1) the incidence of DD in SCI patients; 2) the nature and severity of DD injuries; 3) the accuracy of TBI diagnosis in SCI
patients; and 4) the medical, vocational, functional and psychological
outcomes of DD patients.
METHODS: Consecutive traumatic SCI admissions to a tertiary
metropolitan spinal rehabilitation service in Sydney, Australia, were
eligible for the study. DD was classified where evidence of a TBI was
found in the acute hospital medical records or the rehabilitation service’s database. Consenting DD patients were assessed via a battery of validated questionnaires covering the domains of medical, functional, and psychosocial function.
RESULTS: Of 199 traumatic SCI admissions, 74 (37%) had con-comitant TBI. Of these, only half had been identified in the rehabilitation service’s database. SCIs were cervical in 35%, thoracic in 53% and lumbar in 12%, with 50% complete (ASIA A). 68% of TBIs were severe to extremely severe. 34 DD participants were interviewed between 1 and 6 years post-injury. Common medical complaints in-
cluded bowel=bladder dysfunction, fatigue, sexual dysfunction and chronic pain. 30% reported ‘‘often’’ experiencing cognitive difficulties such as memory and attention impairment. Around one quarter endorsed depressive or anxiety-related symptoms. Most were in paid work or study (68%), while 36% required personal care=support.
CONCLUSION: DD was very common and often undiagnosed on entering spinal rehabilitation. Medical, cognitive and psychosocial issues were common. Future research should compare outcomes between DD patients and their single diagnosis TBI=SCI peers to determine whether acquiring combined SCI=TBI incurs additional personal disability
patients; and 4) the medical, vocational, functional and psychological
outcomes of DD patients.
METHODS: Consecutive traumatic SCI admissions to a tertiary
metropolitan spinal rehabilitation service in Sydney, Australia, were
eligible for the study. DD was classified where evidence of a TBI was
found in the acute hospital medical records or the rehabilitation service’s database. Consenting DD patients were assessed via a battery of validated questionnaires covering the domains of medical, functional, and psychosocial function.
RESULTS: Of 199 traumatic SCI admissions, 74 (37%) had con-comitant TBI. Of these, only half had been identified in the rehabilitation service’s database. SCIs were cervical in 35%, thoracic in 53% and lumbar in 12%, with 50% complete (ASIA A). 68% of TBIs were severe to extremely severe. 34 DD participants were interviewed between 1 and 6 years post-injury. Common medical complaints in-
cluded bowel=bladder dysfunction, fatigue, sexual dysfunction and chronic pain. 30% reported ‘‘often’’ experiencing cognitive difficulties such as memory and attention impairment. Around one quarter endorsed depressive or anxiety-related symptoms. Most were in paid work or study (68%), while 36% required personal care=support.
CONCLUSION: DD was very common and often undiagnosed on entering spinal rehabilitation. Medical, cognitive and psychosocial issues were common. Future research should compare outcomes between DD patients and their single diagnosis TBI=SCI peers to determine whether acquiring combined SCI=TBI incurs additional personal disability
| Original language | English |
|---|---|
| Pages (from-to) | A38-A38 |
| Journal | Journal of Neurotrauma |
| Volume | 28 |
| Issue number | 6 |
| DOIs | |
| Publication status | Published - Jun 2011 |