Objective: To assess the unmediated association between neurological impairment and quality of life (QoL) among persons with spinal cord injury (SCI), in the context of both early post-acute and long-term rehabilitation settings.

Design: An observational prospective cross-sectional study.

Setting: Two neurological rehabilitation centers, specializing in spinal cord injury, within a university hospital.

Methods: 156 adults with spinal cord injury in the early post-acute and chronic stages of rehabilitation.

Outcome Measures: Participants were categorized into tetraplegia or paraplegia groups based on neurological level of injury, and into complete or incomplete groups based on American Spinal Injury Association (ASIA) Impairment Scale (AIS) score. QoL was assessed by means of the World Health Organization Quality of Life Assessment-BREF (WHOQOL-BREF), Satisfaction with Life Scale (SWLS), Life Satisfaction Questionnaire (LISAT-9), and Personal Well-Being Index (PWI).

Results: WHOQOL-BREF and PWI predicted Level of Injury group classification and WHOQOL-BREF predicted Setting group classification. None of the questionnaires differentiated between the Type of Injury groups. At the early post-acute stage of rehabilitation, the QoL scores of participants with tetraplegia and paraplegia did not differ significantly, while significantly higher QoL scores were revealed in paraplegics in the long-term setting group.

Conclusions: A direct, unmediated effect of severity of neurological impairment was revealed with the WHOQOL-BREF, which distinguished between the tetraplegia and paraplegia groups, but not between the complete and incomplete injuries. QoL was significantly higher in paraplegia than in tetraplegia following the early post-acute stage of rehabilitation.

目的：在早期急性后和长期康复环境中，评估脊髓损伤 (SCI) 患者的神经功能障碍与生活质量 (QoL) 之间的直接关联。

设计：一项观察性前瞻性横断面研究。

地点：一所大学医院内的两个神经康复中心，专门研究脊髓损伤。

方法： 156 名脊髓损伤成人，处于早期急性和慢性康复阶段。

结果测量：参与者根据神经损伤程度分为四肢瘫痪或截瘫组，根据美国脊髓损伤协会 (ASIA) 损伤量表 (AIS) 评分分为完全组或不完全组。生活质量通过世界卫生组织生活质量评估-BREF (WHOQOL-BREF)、生活满意度量表 (SWLS)、生活满意度问卷 (LISAT-9) 和个人幸福指数 (PWI) 进行评估。

结果： WHOQOL-BREF 和 PWI 预测损伤组分类水平和 WHOQOL-BREF 预测设置组分类。没有一份调查问卷对损伤类型进行区分。在康复的早期急性后阶段，四肢瘫痪和截瘫参与者的生活质量评分没有显着差异，而长期设置组截瘫患者的生活质量评分显着提高。

结论： WHOQOL-BREF 揭示了神经损伤严重程度的直接、非中介效应，区分了四肢瘫痪和截瘫组，但不区分完全损伤和不完全损伤。在康复的早期急性后阶段，截瘫患者的生活质量明显高于四肢瘫痪患者。