A prospective study of the change in quality of life in adults with a newly acquired spinal cord injury

Objective: Spinal cord injury (SCI) is a catastrophic injury impairing body systems and functions with secondary conditions like infections, chronic pain and fatigue having major negative impacts on functionality and well-being. The objective of this research was to conduct a prospective study of the change in health related quality of life (HRQOL) from the hospitalization stage to six months following discharge in adults with SCI. Methods: Participants included 91 adults with SCI, admitted over two-years into three SCI Units in Sydney, Australia. Multiple measures were taken, including socio-demographic and injury-related variables. Health related quality of life (HR-QOL) was assessed using the Short-Form Health Survey (SF-36) on three occasions, the first soon after admission to rehabilitation, the second within 2 weeks of discharge and the third six-months after discharge. Results: After six months of living in the community, QOL of the SCI sample was significantly lower than Australian adult norms for all SF-36 domains except mental health. QOL domains such as physical functioning and vitality significantly improved from admission to discharge and 6 months after discharge. In contrast, SF-36 general health scores had deteriorated significantly 6 months after discharge. There was a non-significant trend for emotional functioning to also deteriorate 6 months after discharge. No improvement in the SF-36 pain interference scores were found over the time of the three assessments. Conclusion: SCI has a substantial negative impact on QOL for domains such as physical functioning, physical role, pain and health. While participants showed some improvement in HR-QOL at discharge and 6 months after discharge, it is a concern that adults with SCI living in the community continue to have significantly lower QOL. Considered advancements in rehabilitation and community strategies will be required to address deficits in QOL in the long-term following SCI.