Blood pressure levels and clinically meaningful changes during inpatient rehabilitation after spinal cord injury: insights from the Dutch Spinal Cord Injury Database.

PURPOSE: To examine in individuals with spinal cord injury (SCI): associations of blood pressure (BP) with demographic, injury, and medication characteristics at admission; changes in BP and heart rate (HR) between admission and discharge; and determinants of clinically meaningful BP changes during inpatient rehabilitation.

METHODS

This retrospective cohort study used data from 1286 individuals with SCI admitted for inpatient rehabilitation. Resting systolic and diastolic BP (SBP, DBP), and HR were measured at admission and discharge.

RESULTS

Most participants were male (63%, mean age of 58 years (SD 16)), and high-level (≥T6; 62%) motor incomplete (80%) SCI. At admission, higher SBP and DBP were associated with higher body mass index, lower neurological lesion level, and motor incomplete SCI; SBP with older age and anti-hypertensive medication use; and DBP with male sex. Between admission and discharge, mean BP and HR did not change, while hypertension and hypotension prevalence decreased. Older age (OR 1.02) and cardiovascular-related medication use (OR 1.97) were associated with clinically meaningful SBP increase, while anti-hypertensive medication use (OR 1.71) was associated with SBP decrease.

CONCLUSIONS

Despite unchanged mean BP in individuals with SCI during inpatient rehabilitation, BP levels at admission and changes were associated with demographic, injury, and medication-related factors.