Quality of life and health utility scores among Canadian traumatic spinal cord injury patients – A national cross-sectional study
National, multicenter, cross-sectional study.Objective.
The goal of this study was to provide overall quality of life (QOL) and health utility (HU) values for patients with traumatic spinal cord injury (SCI) stratified by injury level and neurological status.Summary of Background Data.
Traumatic SCI is a leading cause of disability. Varying injury level and severity generate a spectrum of neurological dysfunction and reduction in long-term QOL.Methods.
The Canadian SCI Community Survey was sent to Canadians living in the community following SCI. The impact of demographics, complications and SCI classification on QOL was assessed using ANOVA, multiple linear regressions and ordinal logistic regression analyses.Results.
There were 1109 respondents with traumatic SCI. ASIA Impairment Scale (AIS) grade was reported to be cervical motor complete in 20%, cervical motor incomplete in 28%, thoracolumbar motor complete in 32%, thoracolumbar motor incomplete in 16% and normal (any level) in 1%. Injury level or AIS grade had no impact on either HU or QOL. The physical component of HRQOL was significantly affected by the neurological level, but not the social or mental components. With a mean health utility score of 0.64 ± 0.12, SCI patients living in the community reported having HRQOL similar to patients following total knee arthroplasty or lumbar spinal stenosis decompression.Conclusion.
QOL or HU measured by generic HRQOL outcome tools should not be used as outcomes to assess the effectiveness of interventions targeting neurological function in traumatic SCI. A disease-specific instrument that captures the nuances specific to spinal cord injury patients is required.Conclusion.
Level of Evidence: 1