Cross-sectional analysis of a mixed retrospective and prospective inception cohort study.
To determine health status, quality of life and socioeconomic situation of people with spinal cord injuries (SCI) 6 years after discharge from a hospital in Bangladesh.
All patients alive 6 years after discharge from a hospital in Bangladesh were interviewed using the SF12 health survey, the SCI Secondary Conditions Scale, the Centre for Epidemiologic Studies Depression Scale (CESD), and the participation in society items of World Health Organisation Disability Assessment Schedule (WHODAS 2.0). Additional questions determined participants’ socioeconomic and employment status.
The cohort comprised 260 participants: 145 used wheelchairs for mobility and 115 were able to walk at discharge. The median (IQR) Mental and Physical Component scores for the SF12 were 54 (49–57) and 44 (40–51) points, respectively. The median scores for the SCI Secondary Conditions Scale, CESD and WHODAS 2.0 were 8 (4–13), 7 (4–13) and 12 (6–17) points, respectively. Fourteen percent of all participants and 23% of those who used wheelchairs had a pressure ulcer at the time of interview. Forty-four percent of participants were unemployed and 65% were living below the poverty line (median (IQR) income, USD 0 (0–91)) per month.
Many people with SCI in Bangladesh are unemployed and living in poverty with a reduced quality of life and participation. Pressure ulcers are a common complication.
Access optionsAccess options
Subscribe to Journal
Get full journal access for 1 year
only $30.08 per issue
All prices are NET prices.
VAT will be added later in the checkout.
Rent or Buy article
Get time limited or full article access on ReadCube.
All prices are NET prices.
Pagliacci MC, Franceschini M, Di Clemente B, Agosti M, Spizzichino L, Gisem. A multicentre follow-up of clinical aspects of traumatic spinal cord injury. Spinal Cord. 2007;45:404–10.
Post MW, van Leeuwen CM. Psychosocial issues in spinal cord injury: a review. Spinal Cord. 2012;50:382–9.
McKinley WO, Jackson AB, Cardenas DD, DeVivo MJ. Long-term medical complications after traumatic spinal cord injury: a regional model systems analysis. Arch Phys Med Rehabil. 1999;80:1402–10.
Krause JS, Saunders LL. Health, secondary conditions, and life expectancy after spinal cord injury. Arch Phys Med Rehabil. 2011;92:1770–5.
Khazaeipour Z, Taheri-Otaghsara SM, Naghdi M. Depression following spinal cord injury: its relationship to demographic and socioeconomic indicators. Top Spinal Cord Inj Rehabil. 2015;21:149–55.
Strauss D, DeVivo M, Shavelle R, Brooks J, Paculdo D. Economic factors and longevity in spinal cord injury: a reappraisal. Arch Phys Med Rehabil. 2008;89:572–4.
Zakrasek EC, Creasey G, Crew JD. Pressure ulcers in people with spinal cord injury in developing nations. Spinal Cord. 2015;53:7–13.
Ahmed N, Quadir MM, Rahman MA, Alamgir H. Community integration and life satisfaction among individuals with spinal cord injury living in the community after receiving institutional care in Bangladesh. Disabil Rehabil. 2018;40:1033–40.
Islam MS, Jahan H, Hossain MS, Patwary MFK. Quality of life among persons with paraplegic spinal cord injury. DCID. 2016;27:102–117.
Kader M, Perera KP, Hossain MS, Islam R. Socio-demographic and injury-related factors contributing to activity limitations and participation restrictions in people with spinal cord injury in Bangladesh. Spinal Cord. 2017;56:239–46.
Kumar N, Gupta B. Effect of spinal cord injury on quality of life of affected soldiers in India: a cross-sectional study. Asian Spine J. 2016;10:267–75.
Scovil CY, Ranabhat MK, Craighead IB, Wee J. Follow-up study of spinal cord injured patients after discharge from inpatient rehabilitation in Nepal in 2007. Spinal Cord. 2012;50:232–7.
Hossain MS, Rahman MA, Herbert RD, Quadir MM, Bowden JL, Harvey LA. Two-year survival following discharge from hospital after spinal cord injury in Bangladesh. Spinal Cord. 2016;54:132–6.
Hossain MS, Rahman MA, Bowden JL, Quadir MM, Herbert RD, Harvey LA. Psychological and socioeconomic status, complications and quality of life in people with spinal cord injuries after discharge from hospital in Bangladesh: a cohort study. Spinal Cord. 2016;54:483–9.
Hossain MS, Harvey LA, Islam MS, Rahman MA, Glinsky JV, Herbert RD. A prediction model to identify people with spinal cord injury who are at high risk of dying within 5 years of discharge from hospital in Bangladesh. Spinal Cord. 2018. https://doi.org/10.1038/s41393-018-0211-y. [Epub ahead of print].
Arora M, Harvey LA, Lavrencic L, Bowden JL, Nier L, Glinsky JV, et al. A telephone-based version of the spinal cord injury-secondary conditions scale: a reliability and validity study. Spinal Cord. 2016;54:402–5.
Kalpakjian CZ, Scelza WM, Forchheimer MB, Toussaint LL. Preliminary reliability and validity of a spinal cord injury secondary conditions scale. J Spinal Cord Med. 2016;30:131–9.
Üstün TBKN, Chatterji S, Rehm J. Measuring health and disability: manual for WHO Disability Assessment Schedule (WHODAS 2.0). Geneva, Switzerland; 2010.
Chi WC, Chang KH, Escorpizo R, Yen CF, Liao HF, Chang FH, et al. Measuring disability and its predicting factors in a large database in Taiwan using the World Health Organization Disability Assessment Schedule 2.0. Int J Environ Res Public Health. 2014;11:12148–61.
Islam N, Khan IH, Ferdous N, Rasker JJ. Translation, cultural adaptation and validation of the English “Short form SF 12v2” into Bengali in rheumatoid arthritis patients. Health Qual Life Outcomes. 2017;15:109.
Jorgensen S, Ginis KA, Iwarsson S, Lexell J. Depressive symptoms among older adults with long-term spinal cord injury: associations with secondary health conditions, sense of coherence, coping strategies and physical activity. J Rehabil Med. 2017;49:644–51.
Cook KF, Kallen MA, Bombardier C, Bamer AM, Choi SW, Kim J, et al. Do measures of depressive symptoms function differently in people with spinal cord injury versus primary care patients: the CES-D, PHQ-9, and PROMIS®-D. Qual Life Res. 2017;26:139–48.
American Psychiatric Assoc United States of America. Diagnostic and statistical manual of mental disorders (5th edition) - DSM-5. 2013.
The World Bank. Poverty and equity data portal. http://povertydata.worldbank.org/poverty/home/. Accessed on 5 Oct 2018.
Kovindha A, Kammuang-Lue P, Prakongsai P, Wongphan T. Prevalence of pressure ulcers in Thai wheelchair users with chronic spinal cord injuries. Spinal Cord. 2015;53:767–71.
Lofvenmark I, Wikmar LN, Hasselberg M, Norrbrink C, Hultling C. Outcomes 2 years after traumatic spinal cord injury in Botswana: a follow-up study. Spinal Cord. 2017;55:285–9.
Moshi H, Sundelin G, Sahlen KG, Sorlin A. Traumatic spinal cord injury in the north-east Tanzania—describing incidence, etiology and clinical outcomes retrospectively. Glob Health Action. 2017;10:1355604.
Haisma JA, van der Woude LH, Stam HJ, Bergen MP, Sluis TA, Post MW, et al. Complications following spinal cord injury: occurrence and risk factors in a longitudinal study during and after inpatient rehabilitation. J Rehabil Med. 2007;39:393–8.
New PW. Secondary conditions in a community sample of people with spinal cord damage. J Spinal Cord Med. 2016;39:665–70.
Brinkhof MW, Al-Khodairy A, Eriks-Hoogland I, Fekete C, Hinrichs T, Hund-Georgiadis M, et al. Health conditions in people with spinal cord injury: Contemporary evidence from a population-based community survey in Switzerland. J Rehabil Med. 2016;48:197–209.
World Health Organization. International classification of functioning, disability and health – ICF. Geneva; 2001.
Noonan V, Kopec J, Mâsse L, Dvorak M. Measuring participation among persons with spinal cord injury: comparison of three instruments. Top Spinal Cord Inj Rehabil. 2010;15:49–62.
Borg J. Assistive technology, human rights and poverty in developing countries. Perspective based on a study in Banladesh, in Social Medicine and Global Health. Lund University: Lund, Helsingborg and Malmo; 2011.
Deconinck H. The health condition of spinal cord injuries in two Afghan towns. Spinal Cord. 2003;41:303–9.
Bickenbach J, Bodine C, Brown D, Burns A, Campbell R, Cardenas D, et al. International perspectives on spinal cord injury. Geneva: World Health Organization and ISCoS; 2013.
Borg J, Lindstrom A, Larsson S. Assistive technology in developing countries: national and international responsibilities to implement the Convention on the Rights of Persons with Disabilities. Lancet. 2009;374:1863–5.
Gosselin RA, Coppotelli C. A follow-up study of patients with spinal cord injury in Sierra Leone. Int Orthop. 2005;29:330–2.
Singh R, Dhankar SS, Rohilla R. Quality of life of people with spinal cord injury in Northern India. Int J Rehabil Res. 2008;31:247–51.
Kalyani HH, Dassanayake S, and Senarath U. Effects of paraplegia on quality of life and family economy among patients with spinal cord injuries in selected hospitals of Sri Lanka. Spinal Cord. 2015;53:446–50.
Nahar N, Nuri MRP, Mahmud I. Financial aid for the rehabilitation of individuals with spinal cord injuries in Bangladesh. DCID. 2012;23.
Whitehurst DG, Engel L, Bryan S. Short Form health surveys and related variants in spinal cord injury research: a systematic review. J Spinal Cord Med. 2014;37:128–38.
Tasiemski T, Priebe M, Wilski M. Life satisfcation and life values in people with spinal cord injury living in three Asian countries: a multicultural study. J Spinal Cord Med. 2013;36:118–26.
Johnson RL, Gerhart KA, McCray J, Menconi JC, Whiteneck GG. Secondary conditions following spinal cord injury in a population-based sample. Spinal Cord. 1998;36:45–50.
Hartoonian N, Hoffman JM, Kalpakjian CZ, Taylor HB, Krause JK, Bombardier CH. Evaluating a spinal cord injury-specific model of depression and quality of life. Arch Phys Med Rehabil. 2014;95:455–65.
Muller R, Peter C, Cieza A, Geyh S. The role of social support and social skills in people with spinal cord injury—a systematic review of the literature. Spinal Cord. 2012;50:94–106.
Schimmack U, Radhakrishnan P, Oishi S, Dzokoto V, Ahadi S. Culture, personality, and subjective well-being: integrating process models of life satisfaction. J Pers Soc Psychol. 2002;82:582–93.
Tsutsumi A, Izutsu T, Akramul Islam MD, Amed JU, Nakahara S, Takagi F, et al. Depressive status of leprosy patients in Bangladesh: association with self-perception of stigma. Lepr Rev. 2004;75:57–66.
We acknowledge staff members and patients of the Centre for the Rehabilitation of the Paralysed.
MSH conceived the research question, designed the study, collected the data, analysed the data, interpreted the data and wrote the manuscript. LAH and RDH conceived the research question, designed the study, analysed the data, interpreted the data and wrote the manuscript. MSI and MAR collected the data and contributed to the research question, the design of the study, the interpretation of the data and the write-up of the manuscript. JVG and SD contributed to the interpretation of the data and the write-up of the manuscript.
This work was supported by Bridging Support Grants from The University of Sydney [171654 and 2013-00033].
Conflict of interest
The authors declare that they have no conflict of interest.
Statement of ethics
The study received ethical approval (CRP-R&E-0401-218) from CRP and was conducted in accordance with the Declaration of Helsinki. Participants provided informed consent. We certify that all applicable institutional and governmental regulations concerning the ethical use of human volunteers were followed during the course of this research.
Publisher’s note: Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
About this article
Geniposide protects PC12 cells from lipopolysaccharide-evoked inflammatory injury via up-regulation of miR-145-5p
Artificial Cells, Nanomedicine, and Biotechnology (2019)