{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T12:07:45Z","timestamp":1792066065081,"version":"4.4.0"},"reference-count":36,"publisher":"American Medical Association (AMA)","issue":"11","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"\n Importance<\/jats:title>\n While acute complications of traumatic spinal cord injury (TSCI) are well characterized, long-term systemic sequelae remain poorly understood, particularly in previously healthy individuals.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n 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.<\/jats:p>\n <\/jats:sec>\n \n Design, Setting, and Participants<\/jats:title>\n 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.<\/jats:p>\n <\/jats:sec>\n \n Exposure<\/jats:title>\n TSCI.<\/jats:p>\n <\/jats:sec>\n \n Main Outcomes and Measures<\/jats:title>\n \n Incidence of cardiovascular, endocrine, neurologic, and psychiatric conditions, as defined by\n International Classification of Diseases, Ninth Revision<\/jats:italic>\n (\n ICD-9<\/jats:italic>\n ) or\n Tenth Revision<\/jats:italic>\n (ICD-10). Associations between TSCI and comorbidities, and their association with all-cause mortality, were evaluated using multivariable Cox and logistic regression models.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n 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.<\/jats:p>\n <\/jats:sec>\n \n Conclusions and Relevance<\/jats:title>\n In this cohort study, TSCI was associated with increased long-term risk of multisystem morbidity and elevated mortality\u2014even in previously healthy patients. These findings underscore the need for proactive, longitudinal, and multidisciplinary approaches to prevent complications and protect this high-risk population.<\/jats:p>\n <\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2025.41157","type":"journal-article","created":{"date-parts":[[2025,11,4]],"date-time":"2025-11-04T16:00:56Z","timestamp":1762272056000},"page":"e2541157","source":"Crossref","is-referenced-by-count":8,"title":["Traumatic Spinal Cord Injury and Subsequent Risk of Developing Chronic Cardiovascular, Neurologic, Psychiatric, and Endocrine Disorders"],"prefix":"10.1001","volume":"8","author":[{"given":"Ahmad","family":"Mashlah","sequence":"first","affiliation":[{"name":"Divisions of Stroke, Cerebrovascular, and Critical Care Neurology, Department of Neurology, Brigham and Women\u2019s Hospital, Boston, Massachusetts"},{"name":"Harvard Medical School, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandro","family":"Marini","sequence":"additional","affiliation":[{"name":"Divisions of Stroke, Cerebrovascular, and Critical Care Neurology, Department of Neurology, Brigham and Women\u2019s Hospital, Boston, Massachusetts"},{"name":"Harvard Medical School, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hunter","family":"Mills","sequence":"additional","affiliation":[{"name":"Bakar Computational Health Sciences Institute, University of California, San Francisco"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Taha","family":"Yahya","sequence":"additional","affiliation":[{"name":"Divisions of Stroke, Cerebrovascular, and Critical Care Neurology, Department of Neurology, Brigham and Women\u2019s Hospital, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Farid","family":"Radmanesh","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Division of Neurocritical Care, University of Texas Health Science Center, Houston"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joshua","family":"Chalif","sequence":"additional","affiliation":[{"name":"Harvard Medical School, Boston, Massachusetts"},{"name":"Department of Neurosurgery, Brigham and Women\u2019s Hospital, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin E.","family":"Zusman","sequence":"additional","affiliation":[{"name":"Divisions of Stroke, Cerebrovascular, and Critical Care Neurology, Department of Neurology, Brigham and Women\u2019s Hospital, Boston, Massachusetts"},{"name":"Harvard Medical School, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joshua D.","family":"Bernstock","sequence":"additional","affiliation":[{"name":"Harvard Medical School, Boston, Massachusetts"},{"name":"Department of Neurosurgery, Brigham and Women\u2019s Hospital, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maryam H.","family":"Al Mansi","sequence":"additional","affiliation":[{"name":"Divisions of Stroke, Cerebrovascular, and Critical Care Neurology, Department of Neurology, Brigham and Women\u2019s Hospital, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachel","family":"Grashow","sequence":"additional","affiliation":[{"name":"Department of Environmental Health, Harvard T.H. 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Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ali","family":"Salim","sequence":"additional","affiliation":[{"name":"Harvard Medical School, Boston, Massachusetts"},{"name":"Trauma, Burn and Surgical Critical Care, Brigham and Women\u2019s Hospital, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akl C.","family":"Fahed","sequence":"additional","affiliation":[{"name":"Harvard Medical School, Boston, Massachusetts"},{"name":"Division of Cardiology, Department of Medicine, Massachusetts General Hospital, Boston"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Geoffrey T.","family":"Manley","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of California, San Francisco"},{"name":"Institute for Health Policy Studies, University of California, San 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