{"doi":"10.1001/jamanetworkopen.2025.41157","title":"Traumatic Spinal Cord Injury and Subsequent Risk of Developing Chronic Cardiovascular, Neurologic, Psychiatric, and Endocrine Disorders","abstract":"Importance: While acute complications of traumatic spinal cord injury (TSCI) are well characterized, long-term systemic sequelae remain poorly understood, particularly in previously healthy individuals. Objective: To evaluate the long-term risk of neurologic, psychiatric, cardiovascular, and endocrine comorbidities and associated mortality in patients with TSCI compared with matched uninjured controls. Design, Setting, and Participants: This retrospective cohort study analyzed longitudinal data from 2 large hospital-based registries (January 1996 to January 2024): Mass General Brigham (MGB) and the University of California (UC) Health System. Individuals with preexisting diagnoses of studied comorbidities were excluded. Uninjured controls were matched 3:1 by age, sex, and race. The data were analyzed in September to December 2024. Exposure: TSCI. Main Outcomes and Measures: Incidence of cardiovascular, endocrine, neurologic, and psychiatric conditions, as defined by International Classification of Diseases, Ninth Revision (ICD-9) or Tenth Revision (ICD-10). Associations between TSCI and comorbidities, and their association with all-cause mortality, were evaluated using multivariable Cox and logistic regression models. Results: A total of 1038 patients with TSCI in the MGB cohort (602 [58%] male; median [IQR] age, 44 [31-59] years) and 1711 in the UC cohort (1111 [65%] male; median [IQR] age, 45 [32-58] years) were matched with 3114 uninjured control participants in MGB (median [IQR] age, 43 [31-59] years) and 5133 uninjured control participants in UC (median [IQR] age, 45 [31-60] years). Compared with controls, patients with TSCI had significantly higher risk of hypertension (hazard ratio [HR], 1.6; 95% CI, 1.3-1.9), hyperlipidemia (HR, 1.5; 95% CI, 1.3-1.8), ischemic stroke (HR, 2.5; 95% CI, 1.7-3.7), coronary artery disease (HR, 1.8; 95%CI: 1.3-2.5), and diabetes (HR, 1.5; 95% CI, 1.1-2.1), along with other neurologic and psychiatric conditions. The risk of post-TSCI comorbidities was elevated across different age groups, including patients aged 18 to 45 years compared with age-matched controls, with higher rates of hypertension (HR 1.5, 95% CI 1.1-2.1) and ischemic stroke (HR 2.8, 95% CI 1.3-6.0) observed in the TSCI group. Similar findings were seen in a separate cohort of 1711 patients with TSCI from UC Health. Postinjury hypertension (odds ratio [OR], 2.0; 95% CI, 1.2-3.5), pituitary dysfunction (OR, 6.5; 95% CI, 1.1-33.2), adrenal insufficiency (OR, 5.0; 95% CI, 1.04-20.2), depression (OR, 2.9; 95% CI, 1.6-5.2), substance misuse (OR, 4.0; 95% CI, 1.5-9.8), seizures (OR, 6.4; 95% CI, 2.7-14.5), and dementia (OR, 4.8; 95% CI, 2.0-11.6) were associated with higher mortality. Conclusions and Relevance: In this cohort study, TSCI was associated with increased long-term risk of multisystem morbidity and elevated mortality-even in previously healthy patients. These findings underscore the need for proactive, longitudinal, and multidisciplinary approaches to prevent complications and protect this high-risk population.","journal":"JAMA Network Open","year":2025,"id":522300,"datarank":0.26876392038420827,"base_score":1.791759469228055,"endowment":1.791759469228055,"self_citation_contribution":0.26876392038420827,"citation_network_contribution":0.0,"self_endowment_contribution":0.26876392038420827,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":5,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9669,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2025-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1389062,"name":"Sandro Marini","orcid":"0000-0001-9101-6996","position":1,"is_corresponding":false},{"id":51597,"name":"Hunter Mills","orcid":null,"position":2,"is_corresponding":false},{"id":747218,"name":"Taha Yahya","orcid":"0009-0009-6636-0117","position":3,"is_corresponding":false},{"id":1248252,"name":"Farid Radmanesh","orcid":"0000-0001-5431-0176","position":4,"is_corresponding":false},{"id":858970,"name":"Joshua I. Chalif","orcid":"0000-0003-1769-5120","position":5,"is_corresponding":false},{"id":716796,"name":"Benjamin E. Zusman","orcid":"0000-0003-2887-8934","position":6,"is_corresponding":false},{"id":232582,"name":"Joshua D. Bernstock","orcid":"0000-0002-7814-3867","position":7,"is_corresponding":false},{"id":1393776,"name":"Maryam H. Al Mansi","orcid":"0000-0003-4975-6629","position":8,"is_corresponding":false},{"id":467633,"name":"Rachel Grashow","orcid":"0000-0001-6961-0243","position":9,"is_corresponding":false},{"id":495440,"name":"Muhammad M. Abd‐El‐Barr","orcid":"0000-0001-7151-2861","position":10,"is_corresponding":false},{"id":786940,"name":"Hasan A. Zaidi","orcid":"0000-0003-4570-1321","position":11,"is_corresponding":false},{"id":1317470,"name":"Yi Lü","orcid":"0000-0003-3979-5421","position":12,"is_corresponding":false},{"id":923583,"name":"Alí Salim","orcid":"0000-0002-4719-0505","position":13,"is_corresponding":false},{"id":810315,"name":"Akl C. Fahed","orcid":"0000-0002-4849-6389","position":14,"is_corresponding":false},{"id":30635,"name":"Geoffrey T. Manley","orcid":null,"position":15,"is_corresponding":false},{"id":1256674,"name":"Cathra Halabi","orcid":"0000-0002-0331-8183","position":16,"is_corresponding":false},{"id":296169,"name":"Anthony M. DiGiorgio","orcid":"0000-0002-5710-691X","position":17,"is_corresponding":false},{"id":264450,"name":"Ross Zafonte","orcid":"0000-0002-1050-796X","position":18,"is_corresponding":false},{"id":617515,"name":"Saef Izzy","orcid":"0000-0002-2822-6736","position":19,"is_corresponding":false},{"id":1389642,"name":"Ahmad Mashlah","orcid":null,"position":0,"is_corresponding":true}],"reference_count":36,"raw_metadata":{"citation_network_status":"fetched"},"created_at":"2026-07-19T02:49:54.058858Z","pmid":"41186949","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}