title: Medical complications and patient outcomes in Iranian veterans with spinal cord injury.
abstract: BACKGROUND
  Spinal cord injury [SCI] occurring in military veterans is a disabling and highly morbid event. Often the victims are young active males who sustain these injuries during military conflict and suffer from the complications of the SCI for the rest of their lives.
  
  
  OBJECTIVE
  The aim of the study is to report the epidemiology of Iranian SCI veterans and their health related quality of life, medical complications and patient associated outcomes.
  
  
  METHODS
  A cohort of 1984 patients was examined to investigate the epidemiology of Iranian SCI veterans of the Iraq-Iran War (1980-1988); 1803 out of the total number of SCI records were included. Health monitoring was carried out through scheduled monthly visits by general physicians, followed by interviews with specialists from March 20, 2007, to March 19, 2010. Additional follow-up was conducted by telephone survey.
  
  
  RESULTS
  In all, 174 patients (8.77%) had incomplete injury and the rest had complete injury. the most frequent level of injury was the thoracic level (1256 patients - 63.30%). Pressure ulcers were the most frequent complication (up to 14.7% annual prevalence), followed by reactions to severe stress and adjustment disorders (up to 13.6%) and diabetes (up to 10.1%). In the telephone surveys, kidney and/or urologic disorders were the most frequent reported complaints (21.6%). A total of 101 out of the 1984 SCI veterans died between 2000 and 2010 (~0.5% per year).
  
  
  CONCLUSIONS
  In veterans with spinal cord injury, pressure area ulcers (ICD10:L89), reactions to severe stress and adjustment disorders (ICD10:F43), diabetes mellitus (ICD10:E10-E14) and kidney and/or urologic disorders are common and should be addressed aggressively in healthcare planning and management programs for patients with spinal cord injuries.
authors.affiliation: Janbazan Medical and Engineering Research Center (JMERC), Tehran, Iran.
authors.forename: Masoud
authors.initials: M
authors.lastname: Javadi
authors.affiliation: Sina Trauma and Surgery Research Center, Department of Neurosurgery, Tehran University of Medical Sciences, Iran.
authors.forename: Nima
authors.initials: N
authors.lastname: Hafezi-Nejad
authors.affiliation: Departments of Orthopedic Surgery and Neurological Surgery, Thomas Jefferson University and Rothman Institute, Philadelphia, Pennsylvania, USA.
authors.forename: Alexander R
authors.initials: AR
authors.lastname: Vaccaro
authors.affiliation: Sina Trauma and Surgery Research Center, Department of Neurosurgery, Tehran University of Medical Sciences, Iran.
authors.forename: Vafa
authors.initials: V
authors.lastname: Rahimi-Movaghar
mesh_terms: D000328:Adult; D003920:Diabetes Mellitus / Q000453:epidemiology; D005260:Female; D006801:Humans; D007492:Iran; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000453:epidemiology; D003668:Pressure Ulcer / Q000453:epidemiology; D011446:Prospective Studies; D013119:Spinal Cord Injuries / Q000150:complications*; D014728:Veterans