Journal CME, June 2023: Cardiometabolic risk profiling during spinal cord injury rehabilitation: A longitudinal analysis from the Swiss Spinal Cord Injury (SwiSCI) cohort-Journal CME, June 2023: Cardiometabolic risk profiling during spinal cord injury rehabilitation: A longitudinal analysis from the Swiss Spinal Cord Injury (SwiSCI) cohort

Journal CME, June 2023: Cardiometabolic risk profiling during spinal cord injury rehabilitation: A longitudinal analysis from the Swiss Spinal Cord Injury (SwiSCI) cohort

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A study from the Swiss Spinal Cord Injury (SwiSCI) cohort examined the longitudinal changes in cardiometabolic risk factors during the first inpatient rehabilitation period in individuals with spinal cord injury (SCI). The cohort included 258 adults with traumatic SCI who had no prior history of cardiovascular disease (CVD) or type 2 diabetes. Researchers measured indicators such as blood pressure, lipid profile, fasting glucose, waist circumference, weight, body mass index (BMI), and Framingham Risk Score (FRS) at rehabilitation admission and discharge.<br /><br />Key findings include:<br />1. **Initial Status**: Individuals with paraplegia had higher baseline weight, systolic and diastolic blood pressure, and triglycerides compared to those with tetraplegia. Systolic and diastolic blood pressure, as well as high-density lipoprotein cholesterol (HDL-C) levels, were higher in those with incomplete injuries than in those with complete injuries.<br />2. **Longitudinal Changes**: Over the course of rehabilitation, there was an increase in total cholesterol and HDL-C, as well as an improvement in the lipid ratio. However, significant differences in the changes in other cardiometabolic risk factors were not observed when comparing between motor incomplete and complete injuries. <br />3. **Framingham Risk Score (FRS)**: The majority of participants showed a reduction in FRS by the end of rehabilitation, indicating a decrease in the 10-year risk of the first cardiovascular event. However, one-third of participants remained at moderate to high risk of CVD upon discharge.<br /><br />The study highlights that early screening and preventive strategies for cardiometabolic diseases should be initiated during initial inpatient rehabilitation, as a notable proportion of SCI patients remain at elevated risk. The findings suggest that factors such as lifestyle and physical activity, rather than the level and completeness of neurological injury, play a significant role in the management of cardiometabolic risk among SCI patients.<br /><br />Overall, the study underscores the importance of early intervention and continuous monitoring of cardiometabolic health in SCI patients to mitigate long-term cardiovascular risks.

Keywords

Swiss Spinal Cord Injury

SwiSCI cohort

cardiometabolic risk factors

spinal cord injury

inpatient rehabilitation

Framingham Risk Score

blood pressure

lipid profile

cardiovascular disease

preventive strategies