title: Nutritional and immune status following spinal cord injury: a case controlled study.
abstract: METHODS
  Case controlled study.
  
  
  OBJECTIVE
  To compare nutritional status and immune response in a group of spinal cord injured (SCI) patients with age and gender matched non SCI control subjects.
  
  
  METHODS
  Thirty past patients of the Burwood Hospital Spinal Injuries Unit living locally were enrolled in the study. Age and gender matched non SCI control subjects were selected volunteers from hospital staff. Nutritional status was assessed by generating a Nutritional Risk Score (NRS, Appendix 1) and drawing blood for full blood count, iron studies, red blood cell folate, vitamin B12, ferritin, magnesium, and zinc. Immune status was assessed by vaccination response index (VRI) to Pneumovax 23 vaccine.
  
  
  RESULTS
  Full blood count, iron studies, and testing for red blood cell folate, albumin, prealbumin, vitamin B12, ferritin, magnesium and zinc were normal range for both groups. The SCI group had significantly different median values than controls (P < 0.01) for haemoglobin concentration, white blood cell count, albumin, prealbumin, serum iron and % saturation. Body Mass Index (weight kg/(height cm(2)) was 22.2 (range 15-30) for the SCI group, significantly less than the paired control group index of 26 (range 20-32, P = 0.0004). Median NRS for SCI patients was 2 (range 0-6), compared to 0 (range 2-4) for paired controls (P < 0.0001). Scores ranged from 0 to 2 for each of the five NRS components for the SCI patients and 0 to 3 for the control group. There was no significant difference in the pre- and post-vaccination ratio for IgG, IgA, and IgM response to Pneumovax 23 vaccine.
  
  
  CONCLUSIONS
  We have not identified any nutritional or immune status abnormality in SCI patients, however the SCI patients have a lower value for certain nutritional parameters and BMI. SCI patients however are at only slight risk of nutritional problems given their NRS and their lower normal values for certain nutritional factors.
authors.affiliation: Colorectal Unit, Department of Surgery, Christchurch Hospital, Christchurch, New Zealand.
authors.forename: A C
authors.initials: AC
authors.lastname: Lynch
authors.forename: C
authors.initials: C
authors.lastname: Palmer
authors.forename: A C
authors.initials: AC
authors.lastname: Lynch
authors.forename: A
authors.initials: A
authors.lastname: Anthony
authors.forename: J A
authors.initials: JA
authors.lastname: Roake
authors.forename: J
authors.initials: J
authors.lastname: Frye
authors.forename: F A
authors.initials: FA
authors.lastname: Frizelle
mesh_terms: D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D007109:Immunity; D007070:Immunoglobulin A / Q000097:blood; D007074:Immunoglobulin G / Q000097:blood; D007075:Immunoglobulin M / Q000032:analysis; D008297:Male; D008875:Middle Aged; D009752:Nutritional Status / Q000502:physiology*; D022242:Pneumococcal Vaccines / Q000276:immunology; D013119:Spinal Cord Injuries / Q000097:blood / Q000276:immunology* / Q000503:physiopathology*
chemical_list: D007070:Immunoglobulin A; D007074:Immunoglobulin G; D007075:Immunoglobulin M; D022242:Pneumococcal Vaccines