Citation

Kaminski L, Cordemans V, Cernat E, M'Bra KI, Mac-Thiong JM. J. Neurotrauma 2017; 34(12): 2027-2033.

Affiliation

Department of Surgery, Hôpital du Sacré-cœur de Montréal, Montreal, Quebec, Canada, Orthopedic surgery, Montréal, Quebec, Canada ; Macthiong@gmail.com.

Copyright

(Copyright © 2017, Mary Ann Liebert Publishers)

DOI

10.1089/neu.2016.4955

PMID

28129730

Abstract

Spinal cord injury (SCI) is a devastating condition that affects patient on a personal as well as on a societal level. The objective of the study is to improve the prediction of long-term functional outcome following SCI based on the acute clinical findings. 76 patients with acute traumatic SCI were prospectively enrolled in a cohort study in a single level I trauma center. Spinal Cord Independence Measure (SCIM) at 1 year after the trauma was the primary outcome. Potential predictors of functional outcome were recorded during the acute hospitalization: age, sex, level and type of injury, comorbidities, American Spinal Injury Association (ASIA) Impairment Scale (AIS), ASIA Motor Score (AMS), ASIA Light Touch score (LT), ASIA Pin Prick score (PP), Injury Severity Score (ISS), Traumatic Brain Injury (TBI) and delay from trauma to surgery. A linear regression model was created with the primary outcome modeled relative to the acute clinical findings. Only four variables were selected in the model which performance averaged an R-square of 0.57. In descending order, the best predictors for SCIM at 1 year were: LT, AIS grade, ISS and AMS. One year functional outcome (SCIM) can be estimated by a simple equation that takes into account four parameters of the initial physical examination. Estimating the patient long-term outcome early after traumatic SCI is important in order to define the management strategies that might diminish the costs and to give the patient and family a better view of the long-term expectations.

Language: en

Keywords

MODELS OF INJURY; OUTCOME MEASURES; Spinal cord injury; ASIA impairment scale; Functional outcome; Clinical prediction model.; TRAUMATIC SPINAL CORD INJURY