Kaminski Ludovic, Cordemans Virginie, Cernat Eduard, M'Bra Kouamé Innocent, Mac-Thiong Jean-Marc
1 Service d'orthopédie et de traumatologie de l'appareil locomoteur, Cliniques universitaires Saint-Luc , Brussels, Belgium .
2 Computer Assisted and Robotic Surgery (CARS), Institut de recherche expérimentale et clinique, Université catholique de Louvain , Brussels, Belgium .
J Neurotrauma. 2017 Jun 15;34(12):2027-2033. doi: 10.1089/neu.2016.4955. Epub 2017 Mar 21.
Spinal cord injury (SCI) is a devastating condition that affects patients on both a personal and 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. A total of 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, 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, with performance averaging an R-square value 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.
脊髓损伤（SCI）是一种极具破坏性的疾病，在个人和社会层面都会对患者产生影响。本研究的目的是基于急性临床发现，改善对脊髓损伤后长期功能结局的预测。在一家一级创伤中心，共有76例急性创伤性脊髓损伤患者被前瞻性纳入一项队列研究。创伤后1年的脊髓独立测量（SCIM）是主要结局指标。在急性住院期间记录功能结局的潜在预测因素：年龄、性别、损伤水平和类型、合并症、美国脊髓损伤协会（ASIA）损伤量表（AIS）、ASIA运动评分（AMS）、ASIA轻触觉评分（LT）、ASIA针刺觉评分（PP）、损伤严重程度评分（ISS）、创伤性脑损伤以及从创伤到手术的延迟时间。创建了一个线性回归模型，将主要结局相对于急性临床发现进行建模。模型中仅选择了四个变量，其表现的平均R平方值为0.57。按降序排列，创伤后1年SCIM的最佳预测因素为：LT、AIS分级、ISS和AMS。通过一个考虑初始体格检查四个参数的简单方程，可以估计1年的功能结局（SCIM）。在创伤性脊髓损伤后早期估计患者的长期结局，对于确定可能降低成本的管理策略以及让患者和家属更好地了解长期预期非常重要。
