Recommendations for long-term follow-up care of secondary health conditions in spinal cord injury/disorder: a systematic review.
Inge Eriks-Hoogland, Xavier Jordan, Michael Baumberger and 5 others
PMID 39463853WHAT IT FOUND
No existing guidelines cover all long-term health risks for spinal cord injury.
Specialists should coordinate care to catch issues early, as missing follow-up visits triples mortality risk. Annual check-ups are recommended, though evidence for specific intervals remains limited.
Key findings
01Persons with traumatic SCI who had not received treatment at a specialized center for follow-up care faced a substantially heightened risk of mortality (hazard ratio: 3.62 with CI 2.18–6.02).
02None of the guidelines enhances recommendations on a comprehensive medical follow-up including all relevant health conditions for people with SCI/D.
03Based on the comprehensive and extensive literature research conducted, we recommend regular (annual) follow-up care appointments at specialized SCI clinics.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
The search was limited to English and German publications from 2008 to 2018, potentially missing newer evidence. Most included studies were from high-income countries, limiting generalizability to low- and middle-income settings. The methodological quality of the included evidence was low, with many studies failing to meet reporting standards. Heterogeneity in study designs and outcomes prevented a meta-analysis, so conclusions rely on narrative synthesis.
Declared interests
The authors declare no financial support or conflicts of interest.
The easy way to misread this
Do not assume that annual follow-ups are the only correct frequency for every patient. The review found that while annual checks are recommended, some evidence supports risk-modified frequencies based on injury level and individual health status. Also, the link between missed follow-ups and mortality is from an observational study, so it shows association, not necessarily direct causation.