The Swedish SPinal Cord Injury Study on Cardiopulmonary and Autonomic Impairment (SPICA): Methodology, Cohort Demographics and Initial Results

OBJECTIVE: To present the methodology, cohort demographics and initial results of the Swedish SPinal Cord Injury Study on Cardiopulmonary and Autonomic Impairment (SPICA).

DESIGN: SPICA is based on the Swedish Cardiopulmonary and Bioimage Study (SCAPIS), a study on cardiopulmonary diseases in a cohort of 30 000 people. The assessments in SPICA cover the structure and function of the cardiopulmonary and autonomic systems using bioimaging and functional analyses, together with a study-specific questionnaire and generic and SCI-specific assessment tools. The inclusion criteria were: age 50-65 years, traumatic SCI ≥5 years, injury levels C1-T6, American Spinal Injury Association Impairment Scale A-C.

RESULTS: Of 38 potential participants, 25 comprised the final sample (20% women, mean age 58 years, mean time since injury 28 years). Eight percent had sustained a cardiovascular event, and 72% were classified as a high risk for cardiovascular disease (CVD). Asthma was previously diagnosed in only 8% and none had chronic obstructive pulmonary disease.

CONCLUSION: The risk for CVD in people with severe high-level SCI is a major clinical concern. Forthcoming studies in SPICA will provide new knowledge of cardiopulmonary health in this cohort, which can guide future research and be used to develop long-term management.