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Arch Phys Med Rehabil. 2004 Sep;85(9):1503-8.

Factors associated with risk for subsequent injuries after traumatic spinal cord injury.

Author information

  • Department of Rehabilitation Sciences, Medical University of South Carolina, Charleston 29425, USA. krause@musc.edu



To identify the annual incidence and risk factors for subsequent injury among subjects with preexisting spinal cord injury (SCI).


Cross-sectional, mailed survey.


A specialty hospital in the southeastern United States.


Subjects (N=1328) with SCI participated in this study (response rate, 72%), each of whom met the following inclusion criteria: (1) traumatic SCI with residual impairment American Spinal Injury Association (ASIA) grades A through D, (2) nonsurgical onset, (3) age 18 years or older at the time of the study, and (4) a minimum of 12 months post-SCI.


Not applicable.


A general health assessment survey was used that required participants to report the number of injuries that were severe enough to require treatment in a clinic, emergency department, or hospital in the past year, as well as whether any injury resulted in hospitalization. Risk measures included the Behavioral Risk Factor Surveillance System, CAGE, Zuckerman-Kuhlman Personality Questionnaire, Multidimensional Health Locus of Control scale, and prescription medication usage.


Nineteen percent of participants reported at least 1 injury within the past year, with an annual incidence of.33 when considering those with multiple injuries. Twenty-seven percent of those with at least 1 injury reported 1 or more injury-related hospitalizations in the past year. Being younger; having an ASIA grade D injury; higher sensation-seeking scores; heavy drinking; and prescription medication use for pain, spasticity, depression, and sleep were associated with a greater likelihood of subsequent injuries.


Subsequent injuries impact nearly 20% of people with SCI annually; yet, this problem has received little attention in the literature. Further study is needed to identify the costs, severity, and circumstances surrounding injury to design prevention programs that target risk behaviors.

[PubMed - indexed for MEDLINE]
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