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G201(P) Do baseline blood pressure and heart rate in children with a spinal cord injury vary depending on their level of injury?
  1. E Gustafsson Oberink1,
  2. S Gale1,
  3. A Graham2
  1. 1
  2. 2National Spinal Injury Unit, Stoke Mandeville Hospital, Aylesbury, UK

Abstract

Children with a spinal cord injury may have blood pressure and heart rate differences from the expected values of that age. Understanding this potential problem is important for optimal management.

Aims To establish any association between level of spinal injury and ASIA (American Spinal Injury Association) impairment scale severity score with heart rate, blood pressure and diurnal variation in blood pressure. The association between age, gender and BMI on heart rate and blood pressure was also explored.

Method Retrospective records were reviewed for 32 children admitted to a National Spinal Injury Centre for more than 4 rehabilitation periods between 2011 and 2013 (107 admissions). Patient and injury data were established. The first recorded morning and evening blood pressures and heart rates were collated.

Data was analysed using MS Excel 2010 and IBM SPSS v.20.

Results The mean age at first admission was 10.2 years, 41% were male, and 59% had an injury at or above T6. Only 12% of the admissions had complete cardiovascular data.

The associations between ASIA score and BP centile group; ASIA score and diurnal variation; level of injury and BP centile group; and level of injury and diurnal variation, were not statistically significant.

Increasing age was significantly associated with a lower heart rate (OR 0.094, p value <0.001) and systolic BP with increasing BMI (OR 2.97, 95% CI(1.439, 6.137)

Conclusion The changes observed with age and BMI can be accepted as normal physiological change. That no statistical association between the injury related factors, ASIA score and level of injury, and cardiovascular measures was observed could be due to the poor data quality, and no conclusion can therefore be reached from this finding.

Improved measurement and recording of height, weight and cardiovascular observations is paramount for optimal cardiovascular management in this patient group.

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