Outcomes after Spinal Cord Injury

Abstract

Spinal cord injury (SCI) can have a great impact on for example survival and functioning. This thesis describes research on outcomes of survival and functioning in different phases after SCI. The first study described persons who died during their initial hospital stay after traumatic SCI in the Netherlands in 2010. The majority consisted of elderly and end-of-life decisions were reported in most cases (all non-treatment decisions). In the second study persons admitted to Dutch and Flemish rehabilitation centres between 2002 and 2007 were analysed. Unlike in the past, the majority had a non-traumatic SCI. Although their characteristics clearly differed from those of persons with traumatic SCI, their inpatient rehabilitation was at least as effective. The third study focused on survival and causes of death in a group of persons with SCI followed for six years. Strikingly, over five times more persons died than expected, based on death statistics of the general population with the same age and sex. The most common causes of death were comparable to the general population. The last two studies focused on long-term functional independence and participation. Amongst other things, amenable body characteristics (waist circumference and physical capacity) seem to play a role in long-term functioning. The results underpin the importance of the presence of care providers with knowledge of long-term consequences of SCI in the hospital phase, and provide clues on the importance of an active and healthy lifestyle after SCI