Identification and Management of Cardiometabolic Risk after Spinal Cord Injury: Clinical Practice Guideline for Health Care Providers

The clinical manifestations of this secondary complication of spinal cord injury (SCI) may not be apparent until too late to intervene. [...]CMD has been less of a focus of the SCI community as a whole, compared to the other major secondary conditions of neurogenic bowel and bladder, autonomic dysfu...

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Bibliographic Details
Published in:Topics in spinal cord injury rehabilitation 2018-09, Vol.24 (4), p.379-423
Main Authors: Nash, Mark S, Groah, Suzanne L, Gater, Jr, David R, Dyson-Hudson, Trevor A, Lieberman, Jesse A, Myers, Jonathan, Sabharwal, Sunil, Taylor, Allen J
Format: Article
Language:English
Subjects:
Adults
Body composition
Cardiovascular Diseases - etiology
Clinical medicine
Clinical practice guidelines
Consortia
Cpg
Health hazards
Health Personnel
Humans
Insulin resistance
Medicine
Metabolic Diseases - etiology
Mortality
Obesity
Paralysis
Population
Rehabilitation
Risk Assessment
Risk Factors
Spinal cord injuries
Spinal Cord Injuries - complications
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Summary:The clinical manifestations of this secondary complication of spinal cord injury (SCI) may not be apparent until too late to intervene. [...]CMD has been less of a focus of the SCI community as a whole, compared to the other major secondary conditions of neurogenic bowel and bladder, autonomic dysfunction, respiratory insufficiency, depression, sexual dysfunction, pressure injuries, and venous thromboembolism, which are overt in their presentation and have been addressed in previous guidelines. [...]these recommendations also take into consideration the differences between the body composition and physiology of those with SCI and those without SCI, and the risks of certain interventions for persons with SCI, given the presence of other secondary conditions such as neurogenic bowel, and also acknowledge the challenges to implementing the recommendations within the SCI community. Mark S. Nash, PhD, FACSM, Panel Chair Leonard M. Miller School of Medicine, The University of Miami Miami, FL Suzanne L. Groah, MD, MPH, Panel Co-Chair Medstar National Rehabilitation Hospital Georgetown University Medical Center Washington, DC Summary of Recommendations The overall objective of this guideline is to improve the care of patients with spinal cord injury by guiding clinicians and policymakers with its recommendations. See PDF.] Summary of CMD and Component Risks Accompanying SCI CMD Recommendations: Use the American Heart Association (AHA) definition, and the five constituent hazards of obesity, insulin resistance, dyslipidemia (including individual risks of low high-density lipoprotein cholesterol (HDL-C) and elevated Triglycerides (TG), and hypertension as CMD risk components for persons with SCI.
ISSN:1082-0744
1945-5763
DOI:10.1310/sci2404-379