The Stockholm Spinal Cord Injury Study (SSCIS) is an extensive evaluation of a sample
of 353 subjects with traumatic SCI, constituting 93% of the known regional prevalence
population with this diagnosis. In a previous analysis of this group, symptoms such
as pain, incontinence, sexual dysfunction and neurological deterioration, as well
as secondary complications, such as decubitus ulcers, urinary tract infections, spinal
deformity and fractures, were found to be common. In the present report, we investigate
associations between a few commonly used patient characteristics, ie gender, age at
injury, duration of injury and extent of neurological compromise, and the occurrence
of such problems, to assess differences in vulnerability in SCI subgroups. Results
generally indicate an increased vulnerability in subjects with extensive neurological
deficits, as well as a cumulation of complications with the increasing duration of
injury. However, some exceptions are found, possibly indicating differences in temporal
patterns of the occurrence of various complications, as well as certain gender-, age-,
and lesion-associated variations in vulnerability. Symptoms directly related to the
spinal cord lesion, eg neurogenic pain and neurological deterioration, seem to present
rather soon post-injury. Males are more prone to experience excessive spasticity and
sexual problems. Females experience more fractures and spinal deformity. Younger age
at injury is associated with more spinal deformity but less severe pain problems.
Higher age at injury is not found to be associated with more medical problems, with
the exception of neurogenic pain, among post-acute, post-discharge survivors. The
latter finding does not, however, preclude more such problems in the acute stage,
since the present study neither addresses the pre-discharge period, nor includes information
about mortality. Finally, the ASIA/IMSOP Impairment Scale Grade E-rated subjects were
found to report problems to an extent that underlines the restricted sensorimotor
sense in which this rating reflects recovery.