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Autonomic cardiovascular dysfunction and vitamin D deficiency in pediatric spinal cord injury

Zebracki K, Hwang M, Patt PL, Vogel LC

Journal of pediatric rehabilitation medicine, 2013

279 participants

Abstract

OBJECTIVE: The purpose of this manuscript is to present a general overview and preliminary results of pilot projects of two complications in pediatric spinal cord injury (SCI): autonomic cardiovascular dysfunction and vitamin D deficiency.

METHODS: Retrospective cross-sectional investigations of blood pressures (BP), heart rates (HR), and vitamin D levels were performed.

RESULTS: Among 279 children with SCI, it was observed that baseline BP increases and HR decreases with increasing age. Boys had higher systolic BP and girls had higher HR, but a gender difference in diastolic BP did not emerge. There were no significant associations of baseline BP or HR as a function of injury level, severity, or duration. Among 82 youth with SCI, 79% had vitamin D deficiency or insufficiency. There were no differences in vitamin D status as a function of gender or level of injury. Adolescents, however, were more likely to exhibit deficiency compared to children.

IMPLICATIONS: Because of the clinical significance of autonomic dysreflexia and orthostatic hypotension, baseline BP and HR need to be routinely assessed in youth with SCI. In view of the high prevalence of vitamin D insufficiency in youth with SCI and the risk of complications such as pathological fractures, serum 25-hydroxycholecalciferol levels should be routinely monitored.

How strong is the evidence?

Evidence Hub reads this as a cross-sectional, done in people. Its evidence level is 4 of 5 (Low · observational). Observational designs can show an association but not prove cause. Reported size: 279 participants or records.

How the five levels of evidence work. The level is assigned automatically from the abstract and can be wrong, so check the paper.

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