Department of Neurosurgery, Cleveland Clinic, Cleveland, Ohio.
Center for Healthcare Research and Policy, Case Western Reserve University School of Medicine, MetroHealth Medical Center, Cleveland, Ohio.
Top Spinal Cord Inj Rehabil. 2020;26(4):261-267. doi: 10.46292/sci20-00014. Epub 2021 Jan 20.
To investigate the relationship between blood alcohol concentration (BAC) and neurologic recovery after traumatic spinal cord injury (TSCI) using standardized outcome measures from the International Standards for the Neurological Classification of Spinal Cord Injury (ISNCSCI) examination.
This is a retrospective review of merged, prospectively collected, multicenter data from the Spinal Cord Injury Model Systems Database and institutional trauma databases from five academic medical centers across the United States. Patients with SCI and a documented BAC were analyzed for American Spinal Injury Association Impairment Scale (AIS) motor score, FIM, sensory light touch score, and sensory proprioception score upon admission and discharge from rehabilitation. Linear regression was used for the analysis.
The study identified 210 patients. Mean age at injury was 47 ± 20.5 years, 73% were male, 31% had an AIS grade A injury, 56% had ≥1 comorbidity, mean BAC was 0.42 ± 0.9 g/dL, and the mean Glasgow Coma Score upon arrival was 13.27 ± 4.0. ISNCSCI motor score gain positively correlated with higher BAC (4.80; confidence interval [CI], 2.39-7.22; < .0001). FIM motor gain showed a trend toward correlation with higher BAC, although it did not reach statistical significance (3.27; CI, -0.07 to 6.61; = .055). ISNCSCI sensory light touch score gain and sensory proprioception score gain showed no correlation with BAC ( = .44, = .09, respectively).
The study showed a positive association between higher BAC and neurologic recovery in patients with SCI as measured by ISNCSCI motor score gain during rehabilitation. This finding has not been previously reported in the literature and warrants further study to better understand possible protective physiological mechanisms underlying the relationship between BAC and SCI.
使用国际脊髓损伤神经分类标准(ISNCSCI)检查的标准化结果测量来研究创伤性脊髓损伤(TSCI)后血酒精浓度(BAC)与神经恢复之间的关系。
这是对来自美国五个学术医疗中心的脊髓损伤模型系统数据库和机构创伤数据库的合并、前瞻性收集的多中心数据的回顾性分析。对有 SCI 和记录的 BAC 的患者进行分析,分析其美国脊髓损伤协会损伤量表(AIS)运动评分、FIM、感觉轻触觉评分和感觉本体感觉评分,在入院和康复出院时进行分析。线性回归用于分析。
该研究确定了 210 名患者。损伤时的平均年龄为 47 ± 20.5 岁,73%为男性,31%有 AIS 分级 A 损伤,56%有≥1 种合并症,平均 BAC 为 0.42 ± 0.9 g/dL,到达时的格拉斯哥昏迷评分平均为 13.27 ± 4.0。ISNCSCI 运动评分的增加与较高的 BAC 呈正相关(4.80;置信区间[CI],2.39-7.22;<.0001)。FIM 运动评分的增加与较高的 BAC 呈趋势相关,但未达到统计学意义(3.27;CI,-0.07 至 6.61;=.055)。ISNCSCI 感觉轻触觉评分的增加和感觉本体感觉评分的增加与 BAC 无相关性(=.44,=.09)。
该研究表明,在康复期间,ISNCSCI 运动评分的增加与较高的 BAC 与 SCI 患者的神经恢复之间存在正相关。这一发现以前在文献中没有报道过,需要进一步研究以更好地理解 BAC 与 SCI 之间关系的可能保护生理机制。