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创伤性颈脊髓损伤后 72 小时内的神经预后临床预测因素。

Clinical Predictors of Neurological Outcome within 72 h after Traumatic Cervical Spinal Cord Injury.

机构信息

School of Rehabilitation Medicine, Capital Medical University, Beijing 100068, China.

Department of Spine Surgery, Beijing Bo'ai Hospital, China Rehabilitation Research Center, No. 10, North Jiaomen Road, Fengtai District, Beijing 100068, China.

出版信息

Sci Rep. 2016 Dec 12;6:38909. doi: 10.1038/srep38909.

Abstract

To investigate the prognostic values of clinical factors 72 h within traumatic cervical spinal cord injury (TCSCI). Data were extracted from the medical materials of 57 TCSCI cases. AIS was used as the outcome measure and divided into dichotomous variables by two methods, i.e. "complete(AIS = A)/incomplete(AIS ≠ A) SCI" and "motor complete(AIS = A or B)/incomplete(AIS ≠ A and B) SCI". Relationships between evaluated factors and outcomes were investigated by univariate and multivariate methods. MRI Cord transection (MCT) cases, most significantly related to complete SCIs by univariate analysis (P = 0.006), all showed complete SCIs when discharged, which makes it unsuitable for logistic regression. With MCT cases removed, univariate analysis was conducted again, then logistic regression. At last, only C5 spine injury (P = 0.024, OR = 0.241) was related to complete SCI. Cases with compression flexion injury mechanism (CFIM), most significantly related to motor complete SCIs by univariate analysis (P = 0.001), was also unsuitable for logistic regression for the same reason. At last, C3 spine injury (P = 0.033, OR = 0.068) and high energy injury (P = 0.033, OR = 14.763) were related to motor complete SCIs with CFIM cases removed. The results show that MCT and C5 spine injury are good predictors for complete/incomplete SCIs. CFIM, C3 spine injury and high energy injury are good predictors for motor complete/incomplete SCIs.

摘要

探讨创伤性颈脊髓损伤(TCSCI)72 小时内临床因素的预后价值。数据取自 57 例 TCSCI 患者的病历资料。采用 AIS 作为结局测量指标,并采用两种方法将其分为二分类变量,即“完全(AIS=A)/不完全(AIS≠A)SCI”和“运动完全(AIS=A 或 B)/不完全(AIS≠A 和 B)SCI”。通过单变量和多变量方法研究评估因素与结局之间的关系。MRI 脊髓横断(MCT)病例,单变量分析最显著相关(P=0.006),均显示完全性 SCI,出院时不适合进行逻辑回归。去除 MCT 病例后,再次进行单变量分析,然后进行逻辑回归。最后,只有 C5 脊柱损伤(P=0.024,OR=0.241)与完全性 SCI 相关。压缩弯曲损伤机制(CFIM)病例,单变量分析最显著相关(P=0.001),也因同样原因不适合进行逻辑回归。最后,去除 CFIM 病例后,C3 脊柱损伤(P=0.033,OR=0.068)和高能损伤(P=0.033,OR=14.763)与运动完全性 SCI 相关。结果表明,MCT 和 C5 脊柱损伤是完全/不完全 SCI 的良好预测因子。CFIM、C3 脊柱损伤和高能损伤是运动完全/不完全 SCI 的良好预测因子。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/37bc/5150991/cfdded202ae0/srep38909-f1.jpg

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