Baclofen dosage after traumatic spinal cord injury: A multi-decade retrospective analysis

Ashan Veerakumar, Jennifer J. Cheng, Abraham Sunshine, Xiaobu Ye, Richard D. Zorowitz, William S. Anderson

Research output: Contribution to journalArticlepeer-review

Abstract

Objectives To perform an analysis of oral baclofen dosage in patients with traumatic spinal cord injuries over time and to ascertain the clinical determinants of long-term baclofen dosage trends. Study design Retrospective cohort study of patient records from the PM&R units at the Johns Hopkins Bayview Medical Center and the Johns Hopkins Hospital. Subjects A total of 115 PM&R patients suffering spinal cord injury due to trauma leading to either complete or incomplete paralysis. The modes of injury included were motor vehicle accidents (MVA) (n = 39), gunshot wounds (GSW) (n = 55), falls (n = 17), diving (n = 2), workplace (n = 1) and swimming (n = 1) accidents. The location of injury in the spinal cord was categorized into either cervical (n = 52), thoracic (n = 59), lumbar (n = 2), or unspecified (n = 2). Results From time of injury, an aggregate of all dosage assignments for each patient demonstrated a significant yearly increase in baclofen dosage (1.26 mg/year, p<0.01). Baclofen dosage for MVA cases were seen to rise at 4.99 mg/year (p<0.0001). Kaplan-Meier analysis revealed that GSW patients received their first baclofen dosage earlier than MVA patients (log-rank p<0.05, unadjusted). Conclusions We observed a marginal increase in baclofen dosage over nearly 25 years in a single provider's patient database and observed different timings of first dose between two causes of traumatic SCI. These results provide an estimate of baclofen dosage trends over time after spinal cord injury and may be useful for patient counseling or as a method to assess costs of providing SCI patient care.

Original languageEnglish (US)
Pages (from-to)50-56
Number of pages7
JournalClinical Neurology and Neurosurgery
Volume129
DOIs
StatePublished - Dec 5 2014

Keywords

  • Baclofen
  • Paralysis
  • Spasticity
  • Spinal cord injury

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

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