Quality of life and health challenges among individuals with spinal cord injury in Türkiye: findings from the InSCI dataset.

INTRODUCTION

Spinal cord injury (SCI) is frequently accompanied by secondary health conditions that can compromise participation and overall quality of life (QoL). Using the Turkish arm of the International Spinal Cord Injury (InSCI) Community Survey, we described the sociodemographic and clinical profile of adults with SCI in Türkiye and examined cross-sectional factors associated with higher QoL.

METHODS

Cross-sectional analysis of the official Turkish InSCI survey. Community-dwelling adults with traumatic or non-traumatic SCI were recruited via five Istanbul-based institutions that serve patients from multiple regions of Türkiye. Overall QoL was assessed with a 5-point Likert item and analysed both as a 5-category distribution and as a binary outcome (high QoL = 4-5 vs. low QoL = 1-3). Self-rated overall health was entered as an ordinal explanatory variable. Multivariable logistic regression (complete-case) explored independent correlates of high QoL.

RESULTS

Among 405 participants (mean age 43.95 years; 70.5% male), paraplegia was reported by 77.9% and traumatic SCI by 88.7%. Secondary health conditions were common, including spasticity (61.9%), bladder dysfunction (61.1%), and bowel problems (60.1%); 67.3% reported clinically significant pain (VAS ≥ 4). QoL was rated bad/very bad by 19.7%, neither good nor bad by 56.1%, and good/very good by 24.2%. In adjusted analysis (n = 251), worse self-rated health was consistently associated with lower odds of high QoL (OR 0.25 per one-level worsening; 95% CI 0.15-0.42; p < 0.001), whereas age, sex, time since injury, traumatic etiology, and income were not independently associated.

DISCUSSION: Neutral QoL ratings predominated and symptom burden was high. The association between self-rated health and QoL suggests that perceived health is closely related to overall well-being; however, this finding should be interpreted cautiously because both constructs were assessed using single-item subjective measures.

CONCLUSION

Secondary health conditions are common among people with SCI in Türkiye, and perceived overall health showed the most consistent association with higher QoL after adjustment.