Factors associated with neuropathic pain in Colombian patients with spinal cord injury of traumatic origin: case-control study.

STUDY DESIGN: Case-control study. OBJECTIVES: To identify factors associated with neuropathic pain (NP) in patients with spinal cord injury of traumatic origin (TSCI). SETTING: University Hospital of Valle, Cali, Colombia. METHODS: Study participants were individuals with diagnosis of TSCI who visited a trauma referral center from January 1st, 2016, to December 31st, 2016. Information was retrospectively extracted from the Hospital's Spinal Cord Injury registry and patients' medical records. Cases were defined as patients with NP and controls were those without NP. The exposure of interest was intentional injuries. Individuals were matched by age and stratified into 11 groups of ±3 years each. RESULTS: We found 164 participants with an average age of 34 ± 13 years, of whom 95.1% were male, and 53.6% had NP. Neurogenic bladder and bowel occurred in 94.3% of NP patients. Cause of injury was not associated with NP. Older injuries were protective for NP (>10 years since injury OR = 0.10, 95% CI = 0.03-0.37, p < 0.0001) and neurogenic bladder and bowel were found as risk factors (OR = 5.89, 95% CI = 1.84-18.88; p = 0.003). CONCLUSIONS: Our study uniquely shows time since injury as a protective factor for NP and neurogenic bladder and bowel as a risk factor, while violence was not found associated. This could help guide the scope of future research about NP secondary to SCI.

Epidemiology of traumatic spinal cord injuries in Colombia.

STUDY DESIGN: Retrospective cohort study. OBJECTIVES: To determine the incidence and characteristics of newly injured individuals admitted to a traumatic spinal cord injury (TSCI) referral center during a 4-year period. SETTING: University Hospital of Valle, Cali, Colombia. METHODS: Individuals were identified, and their data was recorded based on the International Spinal Cord Injury Core Data Set. The outcome of interest was the American Spinal Injury Association Impairment Scale (AIS) grade at the last follow-up. RESULTS: There were 491 individuals admitted in the 4-year period. The mean annual incidence of TSCI was 56.27 per million inhabitants. Considering TSCI in individuals exclusively from Cali, the mean annual incidence was 27.78 per million. The leading cause of TSCI was interpersonal violence (47.25%) and falls (33.60%). There was a strong correlation between AIS grade at admission and last follow-up. The most common AIS grade at the last follow-up was E (34.01%) caused mostly by falls (57.48%), followed by A (31.16%) caused mostly by interpersonal violence (76.27%). The reported employment rate dropped from 75.56% to 18.94% before and after TSCI (p < 0.05). AIS grade A was associated with more post-injury complications (p < 0.05). CONCLUSIONS: This is the first cohort study in Colombia describing the incidence and AIS grades of individuals with TSCI from a trauma referral center. Interpersonal violence was overrepresented in this population. Future research should include the evaluation of prevention strategies, as well as research on interventions towards quality improvement in patient care and post-discharge services especially for individuals with AIS grade A.