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Original research
Traumatic spinal cord injury in military personnel versus civilians: a propensity score-matched cohort study
  1. Julio C Furlan1,2,
  2. D Kurban3 and
  3. B C Craven1,2
  1. 1 Division of Physicial Medicine and Rehabilitation, Toronto Rehabilitation Institute – Lyndhurst Centre, Toronto, Ontario, Canada
  2. 2 Division of Physicial Medicine and Rehabilitation, University of Toronto, Toronto, Ontario, Canada
  3. 3 Rick Hansen Institute, Vancouver, British Columbia, Canada
  1. Correspondence to Dr Julio C Furlan, Division of Physicial Medicine and Rehabilitation, Toronto Rehabilitation Institute - Lyndhurst Centre, Toronto, ON M4G 3V9, Canada; jcfurlan{at}gmail.com

Abstract

Introduction Military personnel are exposed to mechanisms of bodily injuries that may differ from civilians. A retrospective cohort study (RCS) and a propensity score-matched cohort study (PSMCS) were undertaken to examine the potential differences in injury epidemiology, management and outcomes after spinal cord injury (SCI) between military personnel and civilians.

Methods Using a Canadian multicentre SCI database, data of all individuals with sufficient data from October 2013 to January 2017 were included in the RCS (n=1043). In the PSMCS, a group of 50 military personnel with SCI was compared with a group of 50 civilians with SCI who were matched regarding sex, age, and level, severity and mechanism of SCI.

Results In the RCS, military personnel with SCI (n=61) were significantly older and predominantl males when compared with civilians with SCI (n=982). However, the study groups were not statistically different with regards to their: level, severity and mechanisms of SCI; frequency of associated bodily injuries; and need for mechanical ventilation after SCI. In the PSMCS, the group of military individuals with SCI (n=50) was similar to the group of civilians with SCI (n=50) regarding pre-existing medical comorbidities, degree of motor impairment at admission, initial treatment for SCI and clinical and neurological outcomes after SCI.

Conclusions The results of these studies suggest that military SCI group has disproportionally older men at the time of injury compared with civilians with SCI. However, the military and civilian SCI groups had similar outcomes of alike initial treatment when both groups were matched regarding their demographic profile and injury characteristics.

  • spinal cord injury
  • neurotrauma
  • military
  • civilian

http://dx.doi.org/10.1136/jramc-2019-001197

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    Footnotes

    • Contributors All authors had significant contribution in this study and manuscript writing.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent for publication Not required.

    • Ethics approval Each site participating in the Rick Hansen Spinal Cord Injury Registry Network obtained their own REB approval before data collection.

    • Provenance and peer review Not commissioned; internally peer reviewed.

    • Data sharing statement No data are available.