Quality of life in the subacute period following a cervical traumatic spinal cord injury based on the initial severity of the injury: a prospective cohort study

Study design Prospective cohort study. Objectives To evaluate the relationship between quality of life (QOL) after a traumatic spinal cord injury (TSCI) and acute predictors, with a particular emphasis on the initial severity of the neurological injury. Secondarily, to compare the QOL after a TSCI with the general population. Setting A single Level-1 SCI-trauma centre. Methods A cohort of 119 individuals admitted after a cervical TSCI between April 2010 and September 2016 was studied. QOL was assessed using the SF-36v2 questionnaire 6-12 months following the injury, and compared to the general population. The relationship between the initial severity of the neurological injury and the SF-36 summary scores was assessed using linear multivariable regression analyses. Results Individuals sustaining less severe neurological injury (grade D) exhibited higher PCS than individuals with grades A, B or C injury. Individuals with initial grade A injury showed increased MCS than individuals with incomplete grade B, C or D injury, with 42.9% scoring higher than the general population. The initial grade was significantly associated with chronic PCS and MCS. Conclusions The initial severity of the neurological injury after a cervical TSCI may be used to estimate QOL in the subacute period following the injury. Individuals with complete tetraplegia may report good mental QOL despite severe physical impairment. Our findings could help clinicians to determine realistic expectations for patients in terms of QOL, and optimize the rehabilitation plan based on the initial evaluation after a TSCI.