Long term health consequences of chronic spinal cord injury
Donovan, Kelsey L.
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BACKGROUND: A spinal cord injury (SCI) often results from a traumatic fracture or dislocation of the vertebral structures causing the spinal cord or surrounding nerves to become bruised, crushed or severed. Spinal cord injuries can leave an individual with a range of deficits from nerve impingement to life-threatening complete paralysis. There are hundreds of thousands of Americans living every day with various forms paralysis. Although advancements in acute care and rehabilitative medicine have transpired, individuals with chronic SCIs combat a number of secondary health complications and frequently encounter premature death. LITERATURE REVIEW FINDINGS: The neurologic dysfunction that ensues causes a vast number of secondary health complications including skin breakdown, osteoporosis, diabetes mellitus, dyslipidemia, blood pressure dysfunction, cardiovascular disease and frequently premature death. This comprehensive literature review focuses on these secondary health consequences of chronic spinal cord injuries. Current evidence has presented healthcare providers with guidelines to identify and manage health consequences in the general population. There is a lack of acknowledgement to the SCI population within these guidelines, yet, this subset of patients is, on average, found to have higher rates of osteoporotic fractures, infections, diabetes, dyslipidemia, cardiovascular events and depression due to their sedentary lifestyles. PROPOSED METHODS: The proposed hypothesis of this study states that Primary Healthcare providers will appropriately identify risk factors for secondary illness and proactively manage long-term care for patients with spinal cord injuries after completing CME training. CME seminars will be available for primary healthcare providers to attend at national AAFP, AAPA and AANP conferences. CONCLUSIONS: A SCI can be one of the most life altering experiences as one’s physical, social and psychological welfare are challenged. Beyond these discernible obstacles, lies a life of adverse health consequences linked with significantly reduced lifespans. By educating Physicians, Physician Assistants and Nurse Practitioners about health consequences in the chronic SCI population the care will become centralized and patient-provider relationships will be strengthened. CLINICAL SIGNIFICANCE: In the current medical model, there is a lack of provider education regarding SCI health consequences and subsequently care becomes fragmented to many different subspecialty providers. Educating the primary healthcare providers creates awareness and supports the need for further research in the field of chronic SCI.