Institute of Molecular Regenerative Medicine, Paracelsus Medical University, Salzburg, Austria.
Spinal Cord Injury and Tissue Regeneration Center Salzburg (SCI-TReCS), and ParaMove, Paracelsus Medical University, Salzburg, Austria.
Neurorehabil Neural Repair. 2021 Apr;35(4):321-333. doi: 10.1177/1545968321992328. Epub 2021 Feb 22.
Spinal cord injury (SCI) leads to various degrees of lifelong functional deficits. Most individuals with incomplete SCI experience a certain degree of functional recovery, especially within the first-year postinjury. However, this is difficult to predict, and surrogate biomarkers are urgently needed.
We aimed to (1) determine if routine blood chemistry parameters are related to neurological recovery after SCI, (2) evaluate if such parameters could predict functional recovery, and (3) establish cutoff values that could inform clinical decision-making.
We performed a post hoc analysis of routine blood chemistry parameters in patients with traumatic SCI (n = 676). Blood samples were collected between 24 and 72 hours as well as at 1, 2, 4, 8, and 52 weeks postinjury. Linear mixed models, regression analysis, and unbiased recursive partitioning (URP) of blood chemistry data were used to relate to and predict walking recovery 1 year postinjury.
The temporal profile of platelet counts and serum levels of albumin, alkaline phosphatase, and creatinine differentiated patients who recovered walking from those who remained wheelchair bound. The 4 blood chemistry parameters from the sample collection 8 weeks postinjury predicted functional recovery observed 1 year after incomplete SCI. Finally, URP defined a cutoff for serum albumin at 3.7 g/dL, which in combination with baseline injury severity differentiates individuals who regain ambulation from those not able to walk. Specifically, about 80% of those with albumin >3.7 g/dL recovered walking.
Routine blood chemistry data from the postacute phase, together with baseline injury severity, predict functional outcome after incomplete SCI.
脊髓损伤（SCI）导致终身不同程度的功能缺陷。大多数不完全性 SCI 的患者会经历一定程度的功能恢复，尤其是在损伤后 1 年内。然而，这很难预测，因此迫切需要替代生物标志物。
我们旨在（1）确定常规血液化学参数与 SCI 后的神经恢复是否相关，（2）评估这些参数是否可以预测功能恢复，以及（3）确定可以为临床决策提供信息的截止值。
我们对 676 例创伤性 SCI 患者的常规血液化学参数进行了回顾性分析。在损伤后 24 至 72 小时以及 1、2、4、8 和 52 周采集血液样本。线性混合模型、回归分析和无偏递归分割（URP）的血液化学数据分析用于研究与预测 1 年后步行恢复情况的关系。
血小板计数和血清白蛋白、碱性磷酸酶和肌酐水平的时间变化轨迹区分了能够恢复行走的患者和仍需轮椅辅助的患者。在损伤后 8 周采集的 4 种血液化学参数可以预测不完全性 SCI 1 年后的功能恢复情况。最后，URP 定义了血清白蛋白的截止值为 3.7 g/dL，该值与基线损伤严重程度相结合，可以区分能够重新行走的个体和无法行走的个体。具体来说，约 80%的白蛋白>3.7 g/dL 的患者可以恢复行走。
急性后期的常规血液化学数据，结合基线损伤严重程度，可预测不完全性 SCI 后的功能结局。
