Quality of Life and Function from Initial Injury to Follow-up in the First Year after Traumatic Spinal Cord Injury

Abstract

We assessed the extent to which initial injury severity, functional independence, and health-related quality of life (QoL) predict overall QoL in adults during their first year of recovery following a traumatic spinal cord injury (SCI). Data were collected from two level-I trauma centers and outpatient follow-up care as part of the longitudinal, prospective, and multicenter Transforming Research and Clinical Knowledge in SCI study. Participants included adults with traumatic SCI presenting acutely within 24-h of injury (N = 115). Functional independence was measured using the Spinal Cord Independence Measure Version III, health-related QoL was measured using 11 short-form questionnaires from the QoL in Neurological Disorders (Neuro-QoL) measurement system, and overall QoL was measured using the International SCI QoL Basic Data Set. Injury severity and functional independence measures were not significant predictors of overall QoL. Ten of the 11 Neuro-QoL questionnaires were strongly associated with overall QoL (p ≤ 0.001–0.015). In a multivariable regression model, depression (p = 0.002) and satisfaction with social roles/activities (p < 0.001) maintained significance with overall QoL at 6–12 months post-SCI. Findings indicate that patient-reported mental and social well-being may be more important to overall QoL than injury severity, functional independence, or physical health-related QoL during the first year of recovery following traumatic SCI. This reveals the importance of incorporating mental and social health care plans during early SCI rehabilitation.