Document Detail


Blood pressure and age associated with silent autonomic dysreflexia during urodynamic examinations in patients with spinal cord injury.
MedLine Citation:
PMID:  23229618     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Study design:An observational study.Objectives:To investigate the factors associated with silent autonomic dysreflexia (AD) during urodynamics (UD) in spinal cord injury (SCI) patients.Setting:Taichung city, Taiwan, ROC.Methods:Blood pressure (BP) and symptoms of AD were continuously monitored during UD, and systolic blood pressure (SBP) elevations >20 mmHg was considered an AD reaction. AD patients were divided into a symptomatic group and a silent group (without AD symptoms), and variables (basic demographic data, hemodynamic data and UD parameters) were compared.Results:A total of 42 patients, 21 in symptomatic and 21 in silent AD groups, were analyzed. Symptomatic group had significantly greater diastolic blood pressure (DBP) increment and rates of SBP/DBP changes (change of BP divided by duration) as compared to the silent group (29.5 vs 21.7 mmHg; 4.8 vs 2.3 mmHg min(-1) and 2.8 vs 1.4 mmHg min(-1)) (P<0.05). The cutoff points of these three variables, determined by receiver operating characteristic analysis, are: DBP increment of 21 mmHg and rates of SBP/DBP change of 2.27 and 1.16 mmHg min(-1). Age had a weak negative correlation with DBP change (Pearson's r=-0.377, P=0.048) and the silent group was significantly older than the symptomatic group (49.4 vs 40.1 years, P<0.05).Conclusion:Patients with more symptomatic AD tended to have significant DBP elevation and more rapid SBP/DBP increments, and this was negatively correlated with age. Aging decreases AD symptoms and the magnitude of DBP elevation, possibly through the mechanism of decreased baroreceptor sensitivity. BP monitoring during UD and other invasive procedures is strongly recommended, especially for elderly SCI patients.Spinal Cord advance online publication, 11 December 2012; doi:10.1038/sc.2012.155.
Authors:
Y-H Huang; L-I Bih; J-M Liao; S-L Chen; L-W Chou; P-H Lin
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-12-11
Journal Detail:
Title:  Spinal cord     Volume:  -     ISSN:  1476-5624     ISO Abbreviation:  Spinal Cord     Publication Date:  2012 Dec 
Date Detail:
Created Date:  2012-12-11     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9609749     Medline TA:  Spinal Cord     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
1] School of Medicine, Chung Shan Medical University, Taichung, Taiwan [2] Department of Physical Medicine and Rehabilitation, Chung Shan Medical University Hospital, Taichung, Taiwan.
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