Sociodemographic and Clinical Characteristics and Their Changes in Women with High Tetraplegia

Purpose: The study's aim was to compare women with and without high tetraplegia with respect to sociodemographic, clinical, and functional characteristics and their changes after spinal cord injury (SCI). A secondary aim was to compare, within the population of women with high tetraplegia, subgroups of women with major versus minor neurologic deficits. Method: This study was a case series comprising a total of 2,813 women from the National Spinal Cord Injury Statistical Center (NSCISC) database. The main outcome measures included selected sociodemographic and medical variables, as well as scores in various clinical and functional assessment tools. Results: At the time of injury, women with high tetraplegia were significantly older than those with SCI at or below C5, and the study sample included a higher proportion of married women. The vast majority of participants had high school or lower level of education at the time of injury and a small proportion had a competitive job at their 1-year anniversary. The proportion of women who had pneumonia and pressure sores, were ventilator dependent, and were using indwelling catheters for bladder management was significantly higher among those with high tetraplegia than those with lower levels of injury. The overall proportion of women with neurological improvement from admission to year 1 postinjury was similar among the groups. In contrast, a significantly lower proportion of women with high tetraplegia showed neurological regression. No significant association was found between initial ASIA Impairment Scale (AIS) grade and neurological improvement within the high tetraplegic group. As expected, in both groups women with more incomplete injuries showed higher FIM™ scores as a measure of independent functioning. Analysis of the Craig Handicap Assessment Reporting Technique (CHART) scores by AIS class at year 1 postinjury revealed that women in more incomplete AIS groups reported higher CHART scores, thus reflecting lesser handicap. Conclusion: This study provides unique demographic, clinical, and functional characteristics and their changes in high tetraplegic women as a subgroup within the SCI population