1. The Prevalence of and Contributed Risk Factors of Cardiovascular Diseases among People with Spinal Cord Injury: A Retrospective Study
Ramzi Alajam

2. Outlines Background Objective Methods Results Conclusion
Limitations and future direction

3. Background Spinal cord injury (SCI) Loss of motor and sensory function
Quality of life
Secondary complications
Complete vs. incomplete
Traumatic vs. non-traumatic SCI
More prevalent in men and young population

4. Background Cardiovascular disease (CVD)
The main leading cause of death among SCI population
30-50% in SCI population compared to 5-10% in able-bodied population
17% heart disease in individuals with SCI compared to 5% in those without SCI
6% stroke in individuals with SCI compared to 1.1% in those without SCI

5. Chronic inflammatory status
Background
Hypertension
Chronic inflammatory status
Dyslipidemia
Smoking
Diabetes
Overweight & obesity

6. Questions Are the prevalence rates of CVD different between
Quadriplegic versus paraplegic people?
People with complete versus incomplete?
Which of risk factors contribute significantly in the development of CVD among SCI population?

7. Objectives
To estimate the prevalence rates of heart disease and stroke among people with SCI based on the level and severity of injury.
To determine risk factors that contribute to increase the risk of heart diseases or stroke following SCI.

8. Methods Retrospective study using HERON databases at KUMC
Cohort patients with SCI and diagnosis of
Heart diseases (ischemic heart diseases or heart failure)
Stroke (ischemic or hemorrhagic stroke)
Diagnosis code of ICD-9 and-10

9. Methods Target cohort and variables of interest Target cohort
Another query which included target cohort and factors of interest was built. Diabetes, hypertension, and dyslipidemia were identified using ICD 9 and 10

10. Methods Variables of interest:
Hypertension, diabetes, dyslipidemia (ICD-9 and-10)
Elevated C-reactive protein (laboratory test)
Smoking status and BMI (medical history and visit details)

11. Methods

12. Data and Statistical Analysis
SQLite database Brower
Descriptive statistical analysis

13. Results Overall prevalence of heart diseases and stroke
12 % had heart diseases
11 % had stroke
Heart diseases
No heart diseases
Total
SCI
482
3686
4168
Stroke
No stroke
Total
SCI
452
3816
4268

14. Results Prevalence rate based on level of injury Stroke:
13% in quadriplegia vs. 8% in paraplegia
Heart diseases:
10% in quadriplegia vs. 12% in paraplegia
The odd ratio of heart diseases was 1.2 times higher in paraplegic people compared to quadriplegic people
The odd ratio of stroke was 1.7 times higher in quadriplegic people compared to paraplegic people
Level of SCI
Heart diseases
No heart diseases
Total
Quadriplegia
198
1698
1896
Paraplegia
335
2404
2739
Level of SCI
Stroke
No stroke
Total
Quadriplegia
244
1677
1921
Paraplegia
225
2561
2786

15. Results Prevalence rate based on severity of injury
The prevalence rates of heart diseases and stroke were almost same between people with complete vs. incomplete
Heart diseases:
12.2% in complete SCI vs. 12.5% in incomplete SCI
Stroke:
10.5% in complete SCI vs. 10.7% in incomplete SCI
Severity of SCI
Heart diseases
No heart diseases
Total
Complete 34
244
278
Incomplete 47
329
376
Severity of SCI
Stroke
No stroke
Total
Complete 29
246
275
Incomplete 42
350
392

16. The average time of developing heart diseases was 3.78 years
Result
In 326 individuals (mean age= 60 year-old ; gender(f) = 189(137))
The average time of developing heart diseases was 3.78 years

17. The average time of developing stroke was 3.23 years
Results
In 248 individuals (mean age = 60±17; gender (F) = 137(111))
The average time of developing stroke was 3.23 years

18. Conclusion: The prevalence rate of heart diseases
High in paraplegic people than quadriplegic people
No difference between complete vs. incomplete
The prevalence rate of stroke
High in quadriplegic people than paraplegic people
Development of heart diseases and stroke following SCI
Hypertension, and overweight & obesity.

19. Limitations Limited information about:
Physical activity and mobility status
Severity of injury

20. Future Direction
Investigate the effect of reducing or preventing these risk factors on the development of heart diseases or stroke.

21. Thank You