Department of Neurological Rehabilitation, The Chaim Sheba Medical Center, Tel Hashomer, Israel.
Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel.
Spine (Phila Pa 1976). 2021 Oct 15;46(20):E1089-E1096. doi: 10.1097/BRS.0000000000004053.
A retrospective cohort study.
This study aims to assess the potential value of very early trauma variables such as Abbreviated Injury Scale (AIS) and the Injury Severity Score for predicting independent ambulation following a traumatic spinal cord injury (TSCI).
Several models for prediction of ambulation early after TSCI have been published and validated. The vast majority rely on the initial examination of American Spinal Injury Association (ASIA) impairment scale and level of injury; however, in many locations and clinical situations this examination is not feasible early after the injury.
Patient characteristics, trauma data, and ASIA scores on admission to rehabilitation were collected for each of the 144 individuals in the study. Outcome measure was the indoor mobility item of the Spinal Cord Independence Measure taken upon discharge from rehabilitation. Univariate and multivariable models were created for each predictor, Odds ratios (ORs) were obtained by a multivariable logistic regression analysis, and area under the receiver operator curve was calculated for each model.
We observed a significant correlation between the trauma variables and independent ambulation upon discharge from rehabilitation. Of the early variables, the AIS for the spine region showed the strongest correlation.
These findings support using preliminary trauma variables for early prognostication of ambulation following a TSCI, allowing for tailored individual interventions.Level of Evidence: 3.
回顾性队列研究。
本研究旨在评估创伤后非常早期的变量(如简明损伤定级量表[AIS]和损伤严重程度评分)对预测创伤性脊髓损伤(TSCI)后独立行走的潜在价值。
已经发表并验证了多个用于预测 TSCI 后早期行走的模型。绝大多数模型都依赖于美国脊髓损伤协会(ASIA)损伤量表和损伤水平的初始评估;然而,在许多地点和临床情况下,这种评估在受伤后早期是不可行的。
为研究中的 144 名患者中的每一位收集了患者特征、创伤数据和入院时的 ASIA 评分。出院时的康复室内移动性是脊髓独立性测量的项目。为每个预测指标创建了单变量和多变量模型,通过多变量逻辑回归分析获得比值比(OR),并为每个模型计算了接收者操作特征曲线下的面积。
我们观察到创伤变量与康复出院后的独立行走之间存在显著相关性。在早期变量中,脊柱区域的 AIS 相关性最强。
这些发现支持使用初步创伤变量对 TSCI 后行走进行早期预后预测,从而可以进行个体化的干预。
3 级。