Original Article
Spinal Cord (2008) 46, 65–69; doi:10.1038/sj.sc.3102064; published online 10 April 2007
Orthostatic hypotension in the first month following acute spinal cord injury
E V Sidorov1,2, A F Townson1,3, M F Dvorak1,4, B K Kwon1,4, J Steeves1 and A Krassioukov1,3,5
- 1ICORD, University of British Columbia, Vancouver, British Columbia, Canada
- 2Department of Healthcare and Epidemiology, University of British Columbia, Vancouver, British Columbia, Canada
- 3Division of Physical Medicine and Rehabilitation, Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
- 4Division of Spine, Department of Orthopaedics, University of British Columbia, Vancouver, British Columbia, Canada
- 5School of Rehabilitation, Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
Correspondence: Dr A Krassioukov, ICORD, University of British Columbia, 6270 University Blvd., Vancouver, British Columbia, Canada V6T 1Z4. E-mail: krassioukov@icord.org or sidorov@icord.org
Received 18 September 2006; Revised 14 February 2007; Accepted 4 March 2007; Published online 10 April 2007.
Abstract
Study Design:
Retrospective data analysis.
Objectives:
To determine prevalence of orthostatic hypotension (OH) in patients with spinal cord injury (SCI) during the acute rehabilitation period.
Setting:
Quaternary care spinal unit, Vancouver General Hospital, British Columbia, Canada
Methods:
Eighty-nine patients with acute SCI stratified by neurological level (cervical, 55 (62%); upper thoracic, 12 (13%); lower thoracic, 22 (25%)), and graded by American Spinal Injury Association standards. Non-invasive measurement of systolic and diastolic blood pressure and heart rate were made at baseline and 3 min following an orthostatic challenge test administered during the first month after SCI.
Results:
Patients with cervical or upper thoracic motor complete SCI more frequently experienced OH (P<0.01). OH persisted during the first month following SCI in 74% of cervical and only 20% of upper thoracic motor complete SCI patients.
Conclusion:
Patients with cervical and upper thoracic motor complete SCI are more likely to experience persistent OH than those with lower level or motor incomplete SCI during the first month of rehabilitation.
Keywords:
rehabilitation, orthostatic hypotension, spinal cord injury
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