Risk of Adverse Outcomes after Spinal Cord Injury: A Longitudinal Study

Summary

Principal Investigator: James Krause
Abstract: Spinal cord injury (SCI) heightens risk for adverse health outcomes and secondary conditions, including poor general health, the development of chronic health conditions such as pain and fatigue, and poor Dsychosocial adaptation including an elevated risk for depression. Although there are substantial individual differences in likelihood of developing these conditions, the risk factors that account for the variations are not fully understood, nor have they been systematically investigated. The purpose of the proposed 10-year longitudinal study is to identify differential risk for 3 sets of adverse health outcomes using two empirical models to guide selection of risk variables. The first general risk model highlights conceptual categories of risk variables from multiple levels including behavioral, psycho-social/environmental, and biographic/injury factors in predicting morbidity and mortality. The second bi-dimensional behavioral model assesses the risk of poor health outcomes along independent risk and protective behavioral dimensions. Preliminary data was collected 10 years prior to collection of the proposed follow-up outcome data from 1,391 adult participants with traumatic SCI of at least 1-year duration. These participants will complete a self-report battery of measures as will a new sample of over 1,000 cases. Measures will include reassessment of risk factors and a detailed assessment of health outcomes. General linear model will be used to explore the cross-sectional data as a prelude to confirmatory analyses of the longitudinal data using structural equation modeling (SEM). The SEM will include confirmatory factor analysis to test the clarity of our conceptual categories and independence of our outcome measures, longitudinal change modeling to test the direct effects of time 1 predictors on time 2 outcomes, multiple groups modeling to evaluate hypotheses from our bi-dimensional model, and incomplete data modeling to identify and compensate for selective attrition. Results of the study will enhance our understanding of the natural course of health decline and development of secondary conditions, lead to refined predictive models, and will serve as a basis for developing prevention strategies to limit and/or prevent these conditions among people with SCI.
Funding Period: ----------------2006 - ---------------2011-
more information: NIH RePORT

Top Publications

  1. pmc A prospective study of health and risk of mortality after spinal cord injury
    James S Krause
    College of Health Professions, Medical University of South Carolina, Charleston, SC 29425, USA
    Arch Phys Med Rehabil 89:1482-91. 2008
  2. pmc Ambulation and complications related to assistive devices after spinal cord injury
    Lee L Saunders
    Department of Health Sciences and Research, College of Health Professions, Medical University of South Carolina, Charleston, SC, USA
    J Spinal Cord Med 36:652-9. 2013
  3. pmc Theoretical Risk and Prevention Model for Secondary Health Conditions and Mortality After SCI: 15 Years of Research
    James S Krause
    Department of Health Sciences and Research, College of Health Professions, Medical University of South Carolina, Charleston, South Carolina
    Top Spinal Cord Inj Rehabil 19:15-24. 2013
  4. ncbi Calpain inhibition attenuated morphological and molecular changes in skeletal muscle of experimental allergic encephalomyelitis rats
    Sookyoung Park
    Department of Neurosciences, Medical University of South Carolina, Charleston, South Carolina 29425, USA
    J Neurosci Res 90:2134-45. 2012
  5. pmc Socioeconomic and behavioral risk factors for mortality: do risk factors observed after spinal cord injury parallel those from the general USA population?
    J S Krause
    Department of Health Sciences and Research, College of Health Professions, Medical University of South Carolina, Charleston, SC 29425, USA
    Spinal Cord 50:609-13. 2012
  6. pmc Race-ethnicity and poverty after spinal cord injury
    J S Krause
    Department of Health Sciences and Research, College of Health Professions, Medical University of South Carolina, Charleston, SC, USA
    Spinal Cord 52:133-8. 2014
  7. pmc Behavioral risk factors of mortality after spinal cord injury
    James S Krause
    Dept of Health Sciences and Research, College of Health Professions, Medical University of South Carolina, Charleston, SC 29425, USA
    Arch Phys Med Rehabil 90:95-101. 2009
  8. pmc Risk of hospitalizations after spinal cord injury: relationship with biographical, injury, educational, and behavioral factors
    J S Krause
    Department of Health Sciences and Research, College of Health Professions, Medical University of South Carolina, Charleston, SC 29425, USA
    Spinal Cord 47:692-7. 2009
  9. pmc Risk of mortality after spinal cord injury: relationship with social support, education, and income
    J S Krause
    Department of Health Sciences and Research, Medical University of South Carolina, Charleston, 29425, USA
    Spinal Cord 47:592-6. 2009
  10. pmc Psychologic factors and risk of mortality after spinal cord injury
    James S Krause
    College of Health Professions, Medical University of South Carolina, Charleston, SC, USA
    Arch Phys Med Rehabil 90:628-33. 2009

Scientific Experts

  • James Krause
  • Lee L Saunders
  • Sandra S Brotherton
  • Sookyoung Park
  • Ryan K Kohout
  • D Westerkam
  • Kenkichi Nozaki
  • Swapan K Ray
  • Naren L Banik
  • David C Morrisette
  • Joshua A Smith
  • M Kelly Guyton

Detail Information

Publications28

  1. pmc A prospective study of health and risk of mortality after spinal cord injury
    James S Krause
    College of Health Professions, Medical University of South Carolina, Charleston, SC 29425, USA
    Arch Phys Med Rehabil 89:1482-91. 2008
    ..To test hypothesized relationships between multiple health parameters and mortality among persons with spinal cord injury (SCI) while controlling for variations in biographical and injury characteristics...
  2. pmc Ambulation and complications related to assistive devices after spinal cord injury
    Lee L Saunders
    Department of Health Sciences and Research, College of Health Professions, Medical University of South Carolina, Charleston, SC, USA
    J Spinal Cord Med 36:652-9. 2013
    ..To evaluate long-term health outcomes including pain intensity, pain interference, and fatigue among ambulatory persons with spinal cord injury (SCI)...
  3. pmc Theoretical Risk and Prevention Model for Secondary Health Conditions and Mortality After SCI: 15 Years of Research
    James S Krause
    Department of Health Sciences and Research, College of Health Professions, Medical University of South Carolina, Charleston, South Carolina
    Top Spinal Cord Inj Rehabil 19:15-24. 2013
    ..Conceptual models may aid in identifying the nature of SHCs and guide research, clinical practice, and the development of prevention strategies...
  4. ncbi Calpain inhibition attenuated morphological and molecular changes in skeletal muscle of experimental allergic encephalomyelitis rats
    Sookyoung Park
    Department of Neurosciences, Medical University of South Carolina, Charleston, South Carolina 29425, USA
    J Neurosci Res 90:2134-45. 2012
    ..These results indicate that morphological and molecular changes including apoptotic cell death and protein breakdown develop in skeletal muscle of EAE animals and that these changes can be reversed by calpain inhibition...
  5. pmc Socioeconomic and behavioral risk factors for mortality: do risk factors observed after spinal cord injury parallel those from the general USA population?
    J S Krause
    Department of Health Sciences and Research, College of Health Professions, Medical University of South Carolina, Charleston, SC 29425, USA
    Spinal Cord 50:609-13. 2012
    ..To evaluate the association of demographic, behavioral and socioeconomic factors with all-cause mortality while controlling for health status among a cohort of participants with severe disability related to spinal cord injury (SCI)...
  6. pmc Race-ethnicity and poverty after spinal cord injury
    J S Krause
    Department of Health Sciences and Research, College of Health Professions, Medical University of South Carolina, Charleston, SC, USA
    Spinal Cord 52:133-8. 2014
    ..Secondary analysis of existing data...
  7. pmc Behavioral risk factors of mortality after spinal cord injury
    James S Krause
    Dept of Health Sciences and Research, College of Health Professions, Medical University of South Carolina, Charleston, SC 29425, USA
    Arch Phys Med Rehabil 90:95-101. 2009
    ..To test hypothesized relationships between multiple behavioral indicators and mortality among persons with spinal cord injury (SCI), while controlling for biographic and injury characteristics...
  8. pmc Risk of hospitalizations after spinal cord injury: relationship with biographical, injury, educational, and behavioral factors
    J S Krause
    Department of Health Sciences and Research, College of Health Professions, Medical University of South Carolina, Charleston, SC 29425, USA
    Spinal Cord 47:692-7. 2009
    ..Cross-sectional survey...
  9. pmc Risk of mortality after spinal cord injury: relationship with social support, education, and income
    J S Krause
    Department of Health Sciences and Research, Medical University of South Carolina, Charleston, 29425, USA
    Spinal Cord 47:592-6. 2009
    ..Prospective cohort study...
  10. pmc Psychologic factors and risk of mortality after spinal cord injury
    James S Krause
    College of Health Professions, Medical University of South Carolina, Charleston, SC, USA
    Arch Phys Med Rehabil 90:628-33. 2009
    ..To identify the association of 2 distinct psychologic constructs, personality and purpose in life (PIL), with risk of early mortality among persons with spinal cord injury (SCI)...
  11. pmc A latent variable structural path model of health behaviors after spinal cord injury
    James S Krause
    College of Health Professions, Medical University of South Carolina, Charleston, South Carolina 29425, USA
    J Spinal Cord Med 32:162-74. 2009
    ..To develop a latent behavioral model by identifying and confirming the factor structure of health behaviors of people with spinal cord injury (SCI) and their relationships with biographic, injury, and educational characteristics...
  12. pmc Association between reliance on devices and people for walking and ability to walk community distances among persons with spinal cord injury
    Sandra S Brotherton
    College of Health Professions, Medical University of South Carolina, Charleston, SC 29425, USA
    J Spinal Cord Med 35:156-61. 2012
    ..To identify and describe the frequency of reliance on assistive devices and/or people for ambulating distances and stair climbing...
  13. pmc Association of race, socioeconomic status, and health care access with pressure ulcers after spinal cord injury
    Lee L Saunders
    Department of Health Sciences and Research, College of Health Professions, Medical University of South Carolina, Charleston, SC 29425, USA
    Arch Phys Med Rehabil 93:972-7. 2012
    ..To assess the associations of race and socioeconomic status (SES) with pressure ulcers (PUs) after accounting for health care access among persons with spinal cord injury (SCI)...
  14. pmc Risk of mortality after spinal cord injury: an 8-year prospective study
    James S Krause
    College of Health Professions, Medical University of South Carolina, Charleston, SC, USA
    Arch Phys Med Rehabil 90:1708-15. 2009
    ..Krause JS, Zhai Y, Saunders LL, Carter RE. Risk of mortality after spinal cord injury: an 8-year prospective study...
  15. pmc Behavioral factors related to fatigue among persons with spinal cord injury
    Lee L Saunders
    Department of Health Sciences and Research, College of Health Professions, Medical University of South Carolina, Charleston, SC 29425, USA
    Arch Phys Med Rehabil 93:313-8. 2012
    ..To examine behavioral risk factors in relation to fatigue after spinal cord injury (SCI), specifically cardiovascular-related behaviors, prescription medication use, and alcohol and cigarette use...
  16. pmc Stability of predictors of mortality after spinal cord injury
    J S Krause
    Department of Health Sciences and Research, College of Health Professions, Medical University of South Carolina, Charleston, SC 29425, USA
    Spinal Cord 50:281-4. 2012
    ..Cohort study...
  17. pmc Health, secondary conditions, and life expectancy after spinal cord injury
    James S Krause
    Department of Health Sciences and Research, College of Health Professions, Medical University of South Carolina, Charleston, 29425, USA
    Arch Phys Med Rehabil 92:1770-5. 2011
    ..To evaluate the association of health status, secondary health conditions, hospitalizations, and risk of mortality and life expectancy (LE) after spinal cord injury (SCI)...
  18. pmc Comparison of the Patient Health Questionnaire and the Older Adult Health and Mood Questionnaire for self-reported depressive symptoms after spinal cord injury
    James S Krause
    Department of Health Sciences and Research, Medical University of South Carolina, South Carolina, USA
    Rehabil Psychol 54:440-8. 2009
    ....
  19. pmc A structural analysis of health outcomes after spinal cord injury
    James S Krause
    College of Health Professions, Medical University of South Carolina, 77 President St, Suite 117, PO Box 250700, Charleston, SC 29425, USA
    J Spinal Cord Med 33:22-32. 2010
    ..To develop and validate a latent model of health outcomes among persons with spinal cord injury...
  20. pmc The relationship between prescription medication use and ability to ambulate distances after spinal cord injury
    Ryan K Kohout
    Department of Health Sciences and Research, College of Health Professions, Medical University of South Carolina, 77 President Street, Charleston, SC 29425, USA
    Arch Phys Med Rehabil 92:1246-9. 2011
    ..To investigate the relationship between prescription medication use for pain and spasticity and ambulation distances while controlling for pain severity, injury severity, age, sex, and race in participants with spinal cord injury (SCI)...
  21. pmc Association of spasticity and life satisfaction after spinal cord injury
    D Westerkam
    Davidson College, Davidson, NC, USA
    Spinal Cord 49:990-4. 2011
    ..Cross-sectional survey; secondary analysis of existing data by linear regression analysis between spasticity and quality of life...
  22. pmc Income and risk of mortality after spinal cord injury
    James S Krause
    College of Health Professions, Medical University of South Carolina, Charleston, SC, USA
    Arch Phys Med Rehabil 92:339-45. 2011
    ..To evaluate the association of household income and formal education with risk of mortality after spinal cord injury (SCI)...
  23. pmc Psychological factors affecting alcohol use after spinal cord injury
    L L Saunders
    Department of Health Sciences and Research, College of Health Professions, Medical University of South Carolina, Charleston, SC 29425, USA
    Spinal Cord 49:637-42. 2011
    ..Cross-sectional...
  24. pmc The relationship of pressure ulcers, race, and socioeconomic conditions after spinal cord injury
    Lee L Saunders
    Department of Health Sciences and Research, Medical University of South Carolina, Charleston, South Carolina 29425, USA
    J Spinal Cord Med 33:387-95. 2010
    ..We hypothesize African Americans will have a greater risk for PrUs than whites, but this relationship will be mediated by the 2 socioeconomic status indicators...