Zakrasek Elissa C, Yurkiewicz Shara M, Dirlikov Ben, Pence B Tim, Crew James D
Palo Alto Veterans Affairs Hospital, Palo Alto, CA, USA.
Stanford Hospitals and Clinics, Palo Alto, CA, USA.
Spinal Cord. 2019 Mar;57(3):214-220. doi: 10.1038/s41393-018-0199-3. Epub 2018 Sep 25.
Retrospective chart review.
The objective of this study is to evaluate the efficacy of nonsteroidal anti-inflammatory drug (NSAID) prophylaxis for heterotopic ossification (HO) in the acute phase after spinal cord injury (SCI).
Acute rehabilitation hospital in California, USA.
This retrospective chart review (October 2013-March 2017) included individuals with motor complete SCI followed by the SCI service within 60 days of injury. Group demographics and HO diagnosis were compared in those who received and those who did not receive NSAID prophylaxis. A backward stepwise multiple regression was employed to assess the predictive association between injury characteristics and HO prophylaxis on HO diagnosis.
A total of 108 AIS A and B cases were included, and 27 received ≥ 15 days of therapy (overall range 6-44 days). Logistic regression analysis revealed those who received ≥ 15 days of NSAID prophylaxis had an odds ratio of 0.1 of being diagnosed with HO compared with those who did not (95% CI, 0.02 to 0.52). Significant predictors of HO diagnosis were tracheostomy (OR 2.8, 95% CI, 1.05 to 7.5), urinary tract infection (OR 4.3, 95% CI, 1.5 to 12.2), and pressure injury (OR 3.3, 95% CI, 1.1 to 9.5). Adverse effects of NSAID use were minimal.
NSAID prophylaxis appears to help prevent HO development during the acute phase after SCI. Prospective study with prolonged follow up is necessary to confirm the long-term efficacy of HO prevention and to further evaluate safety following spinal fusion.
None.
回顾性病历审查。
本研究的目的是评估非甾体抗炎药（NSAID）预防脊髓损伤（SCI）急性期异位骨化（HO）的疗效。
美国加利福尼亚州的急性康复医院。
这项回顾性病历审查（2013年10月至2017年3月）纳入了在受伤后60天内接受脊髓损伤服务且运动功能完全性SCI的个体。比较了接受和未接受NSAID预防的患者的组人口统计学和HO诊断情况。采用向后逐步多元回归分析来评估损伤特征与HO预防对HO诊断的预测关联。
共纳入108例AIS A级和B级病例，其中27例接受了≥15天的治疗（总疗程为6 - 44天）。逻辑回归分析显示，接受≥15天NSAID预防的患者被诊断为HO的比值比为0.1，而未接受预防的患者为（95%CI，0.02至0.52）。HO诊断的显著预测因素包括气管切开术（OR 2.8，95%CI，1.05至7.5）、尿路感染（OR 4.3，95%CI，1.5至12.2）和压疮（OR 3.3，95%CI，1.1至9.5）。NSAID使用的不良反应最小。
NSAID预防似乎有助于预防SCI急性期HO的发生。有必要进行长期随访的前瞻性研究，以确认HO预防的长期疗效，并进一步评估脊柱融合后的安全性。
无。
