Prevalence of dyslipidaemia in patients with spinal cord injury: a cross-sectional study.
1Iova G, 1Rouse A, 2Lari S, 3Ussef I, 3Jamous A, 1Graham A, 1Wong S
1National Spinal Injuries Centre, Stoke Mandeville Hospital, Aylesbury, , United kingdom; 2Southport & Ormskirk Hospital, Southport, , United kingdom; 3Royal Buckinghamshire Hospital, Aylesbury, , United kingdom
Objectives: This study aims to (1) assess the uptake of lipid profile screening (LPS); (2) describe the prevalence of dyslipidaemia using ATPIII guideline2 and 10-years CVD risk using QRISK23; (3) describe the characteristics of elevated CVD risk in patients with SCI.
Methods: 1,606 adults were admitted during Jan 2012 to Dec 2016, 529 patients were admitted to spinal rehabilitation wards, 368 (69.5%) patients (mean age: 53 years, 34.4% female) with SCI (44.3% tetraplegia; 31.6% complete SCI) had their baseline lipid profile measured.
Results: The compliance of LPS has improved significantly overtime [2014: 21.3%; 2015: 35.4%; 2016: 65.5%, p<0.01]. Hypercholesterolemia, low HDL-cholesterol, high LDL-cholesterol and hypertriglyceridemia were found in 40.1%, 50%, 34.4% and 54% of patients, respectively. 209 (60.8%) were at risk of developing CVD in the next 10 years (≥10%) and 104 (30.2%) were at high risk (≥20%). Fifty-four (51.9%) high risk patients were on lipid lowering medications. Elevated CVD risk associated with BMI ≥25 kg/m2, p=0.045, systolic blood-pressure >120mmHg, p<0.01 and age ≥60 years, p<0.01 but it was not associated with female gender, tetraplegia, complete injury nor onset of SCI.
Conclusion: The compliance of LPS appears to have improved. A high percentage of apparently healthy SCI patients are at risk of CVD, characterised by low HDL-cholesterol but few are on appropriate treatment. Routine systematic LPS in rehabilitation stage is recommended before SCI-specific CVD guidelines are established for this population.
1. Gilbert et al (2014) Atherosclerosis 232, 305-312;
2. Cleeman et al (2001) JAMA 285, 2486-2497;
3. Hippisley et al (2008) BMJ 336: a332
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