Mitigating risks associated with orthostatic hypotension during rehabilitation in a patient following spinal cord injury: A retrospective case report

Author/ Authors/ Presenter/ Presenters/ Panelists:

Ahmed Dahbur, Governors State UniversityFollow

Type of Presentation

Poster Session

Start Date

4-12-2019 4:00 PM

End Date

4-12-2019 6:00 PM

Abstract

Background/purpose: The incidence of spinal cord injury (SCI) in the United States of America is estimated to be approximately 17,000 individuals per year.1 Following a spinal cord injury, patients often develop cardiovascular complications at some point in time.2 One such cardiovascular complication is orthostatic hypotension. The purpose of this retrospective case report is to describe an approach to managing the secondary risks associated with orthostatic hypotension in a patient with a spinal cord injury.

Case Description: The patient was a 52-year-old Latino-American male admitted to an inpatient subacute facility for rehabilitation following a traumatic spinal cord injury at work. Patient experienced orthostatic hypotension episodes which limited rehabilitation and increased risk of the patient developing secondary complications.

Outcomes: The patient’s blood pressure was stabilized by use of compression stockings, an abdominal binder, and midodrine. The patient significantly increased function and mobility following decreased orthostatic hypotension episodes. He improved to at least Moderate Independence for all functional activity.

Discussion: This case report highlights the importance of managing the rehabilitation of a patient with a spinal cord injury experiencing orthostatic hypotension to reduce risk of deep vein thrombosis, contractures, and pressure injuries. The pace of improvement and functional gains increased following stabilization of the patient’s blood pressure.

Faculty / Staff Sponsor

Dr. Roberta OShea

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Apr 12th, 4:00 PM Apr 12th, 6:00 PM

Mitigating risks associated with orthostatic hypotension during rehabilitation in a patient following spinal cord injury: A retrospective case report

Background/purpose: The incidence of spinal cord injury (SCI) in the United States of America is estimated to be approximately 17,000 individuals per year.1 Following a spinal cord injury, patients often develop cardiovascular complications at some point in time.2 One such cardiovascular complication is orthostatic hypotension. The purpose of this retrospective case report is to describe an approach to managing the secondary risks associated with orthostatic hypotension in a patient with a spinal cord injury.

Case Description: The patient was a 52-year-old Latino-American male admitted to an inpatient subacute facility for rehabilitation following a traumatic spinal cord injury at work. Patient experienced orthostatic hypotension episodes which limited rehabilitation and increased risk of the patient developing secondary complications.

Outcomes: The patient’s blood pressure was stabilized by use of compression stockings, an abdominal binder, and midodrine. The patient significantly increased function and mobility following decreased orthostatic hypotension episodes. He improved to at least Moderate Independence for all functional activity.

Discussion: This case report highlights the importance of managing the rehabilitation of a patient with a spinal cord injury experiencing orthostatic hypotension to reduce risk of deep vein thrombosis, contractures, and pressure injuries. The pace of improvement and functional gains increased following stabilization of the patient’s blood pressure.