title: Assessment of clinical adherence to the international autonomic standards following spinal cord injury.
abstract: METHODS
  Retrospective chart analysis.
  
  
  OBJECTIVE
  To investigate the use of the International Autonomic Standards (IAS, 2009 edition) for classification of remaining autonomic function following spinal cord injury (SCI) over a 1-year period in a rehabilitation center, to determine clinical adherence to use of the IAS, and to examine the most common autonomic dysfunctions, as determined by using the IAS.
  
  
  METHODS
  Tertiary rehabilitation hospital.
  
  
  METHODS
  A retrospective study was conducted on the use of the IAS at admission and discharge over a 1-year period on patients admitted to an in-patient SCI unit in a tertiary rehabilitation center. We examined the consistency of the form completion, as well as the completion of separate components of the forms. Finally, we examined the prevalence of each autonomic impairment.
  
  
  RESULTS
  A total of 70 patients were admitted to the unit. The clinical adherence to the IAS was lower than the International Standards for Neurological Classification of SCI (ISNCSCI) at both admission (63% and 93%, respectively) and discharge (39% and 78%, respectively). Blood pressure dysfunction was most common among the general autonomic function disorders. However, urinary, bowel and sexual dysfunctions were present in almost all individuals with acute SCI.
  
  
  CONCLUSIONS
  The IAS is in the initial stages of being incorporated into routine admission and discharge clinical examinations of individuals with SCI. The current results suggest that the clinical adherence to the IAS is low; however, it is expected that increased education, experience, and accumulating evidence for the IAS will improve its use.
authors.affiliation: International Collaboration on Repair Discoveries (ICORD), Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.
authors.forename: J W
authors.initials: JW
authors.lastname: Squair
authors.affiliation: Department of Medicine, University of Toronto, Toronto, Ontario, Canada.
authors.forename: G
authors.initials: G
authors.lastname: le Nobel
authors.affiliation: Rick Hansen Institute, Vancouver, British Columbia, Canada.
authors.forename: V K
authors.initials: VK
authors.lastname: Noonan
authors.affiliation: Department of Biology, Queens University, Kingston, Ontario, Canada.
authors.forename: G
authors.initials: G
authors.lastname: Raina
authors.affiliation: International Collaboration on Repair Discoveries (ICORD), Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.|Department of Medicine, Division of Physical Medicine and Rehabilitation, University of British Columbia, Vancouver, British Columbia, Canada.|GF Strong Rehabilitation Centre, Vancouver Health Authority, Vancouver, British Columbia, Canada.
authors.forename: A V
authors.initials: AV
authors.lastname: Krassioukov
mesh_terms: D001341:Autonomic Nervous System / Q000503:physiopathology*; D005260:Female; D019983:Guideline Adherence / Q000706:statistics & numerical data; D006801:Humans; D038622:Internationality; D008297:Male; D008875:Middle Aged; D009460:Neurologic Examination / Q000592:standards*; D010343:Patient Admission; D010351:Patient Discharge; D010820:Physicians; D015995:Prevalence; D012047:Rehabilitation Centers; D012189:Retrospective Studies; D013119:Spinal Cord Injuries / Q000145:classification* / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology*; D062606:Tertiary Care Centers
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