Functional Outcome Prediction after Traumatic Spinal Cord Injury Based on Acute Clinical Factors

Abstract

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.

The acute phase serum zinc concentration is a reliable biomarker for predicting the functional outcome after spinal cord injury

“…Wilson et al created a clinical prediction model for determining the long-term functional outcome based on acute clinical and imaging factors obtained within 3 days of injury; however, the coefficient of determination (R 2 ), which measures the accuracy of the model, was 0·52 [16]. Kaminski et al created a functional outcome prediction model based on acute clinical factors, and their R 2 was 0·57 [39]. Matsushita et al and Dalkilic et al reported the correlation between the MRI lesion area and the neurologic prognosis, and their R 2 calculated by the correlation coefficient was 0·28 and 0·29, respectively [12,15].…”

Plasma Erythropoietin, IL-17A, and IFNγ as Potential Biomarkers of Motor Function Recovery in a Canine Model of Spinal Cord Injury

“…To date, several research groups have reported poor feasibility and accuracy of current methods in classifying injury severity and predicting neurologic outcomes due to the heterogeneity of SCI or limitations of each imaging technology (Krishna et al 2014 ; Hicks et al 2017 ). For example, Kaminski et al ( 2017 ) created a prediction model including four different acute clinical parameters associated with an R 2 value of 0.573. Here, we investigated the temporal changes in the expression level of 40 cytokines using cytokine arrays.…”

Epothilone B impairs functional recovery after spinal cord injury by increasing secretion of macrophage colony-stimulating factor

“… 38 However researches on human show gender-related differences in recovery after SCI have not been found. 39 , 40 The evidence of estrogen effects in SCI remains inconclusive. Therefore, the finding of our work tends to fit female rodents.…”