Natural Progression of Routine Laboratory Markers after Spinal Trauma: A Longitudinal, Multi-Cohort Study

Abstract

Our objective was to track and quantify the natural course of serological markers over the 1st year following spinal cord injury. For that purpose, data on serological markers, demographics, and injury characteristics were extracted from medical records of a clinical trial (Sygen) and an ongoing observational cohort study (Murnau study). The primary outcomes were concentration/levels/amount of commonly collected serological markers at multiple time points. Two-way analysis of variance (ANOVA) and mixed-effects regression techniques were used to account for the longitudinal data and adjust for potential confounders. Trajectories of serological markers contained in both data sources were compared using the slope of progression. Our results show that, at baseline (£ 2 weeks post-injury), most serological markers were at pathological levels, but returned to normal values over the course of 6-12 months post-injury. The baseline levels and longitudinal trajectories were dependent on injury severity. More complete injuries were associated with more pathological values (e.g., hematocrit, ANOVA test; v 2 = 68.93, df = 3, adjusted p value <0.001, and v 2 = 73.80, df = 3, adjusted p value <0.001, in the Sygen and Murnau studies, respectively). Comparing the two databases revealed some differences in the serological markers, which are likely attributable to differences in study design, sample size, and standard of care. We conclude that because of trauma-induced physiological perturbations, serological markers undergo marked changes over the course of recovery, from initial pathological levels that normalize within a year. The findings from this study are important, as they provide a benchmark for clinical decision making and prospective clinical trials. All results can be interactively explored on the

Protective effects of muscone on traumatic spinal cord injury in rats

“…Protective effects of muscone on traumatic spinal cord injury in rats categorized into primary and secondary phases (5)(6)(7). A cascade of secondary injury destroys an increasing zone of tissue adjacent to the primary injury site and exacerbates neurological deficits and outcomes (8)(9)(10)(11), such as cellular excitotoxicity, ionic dysregulation, disruption of the bloodspinal cord barrier, free-radical-mediated peroxidation, and immune-inflammatory reactions, which are considered pathological damage-mediating processes during secondary damage (12)(13)(14)(15). Inflammatory cytokines are considered the key regulating substances during immune reactions, which participate in adjusting inflammatory responses in SCI (16)(17)(18).…”

Untargeted blood serum proteomics identifies novel proteins related to neurological recovery after human spinal cord injury

“…In addition, pharmacological management at the very acute and acute phases may interfere with processes suitable of render biomarkers of recovery. On the other hand, in the subacute stage of SCI (from weeks to months after injury), there is still potential for sensorimotor recovery, numerous secondary events develop in various organs and patients are stabilized [ 1 , 11 , 14 ].…”

Factores de riesgo y prevalencia de la lesión medular en adultos: una revisión sistemática

“…Por otra parte, Japón 42%(Uehara et al, 2022), Corea 25%(Kim et al, 2018), India 62%(Neyaz et al, 2020). Lo cual se asemeja a un estudio realizado en China en donde se indica 56%(Jiang et al, 2021) y por último en África se evidenció 43%(Bellet et al, 2019) el cual es similar a la media de esta revisión.En los dos artículos de Europa publicados en España y Suiza se halló prevalencias de 33% y 47%(Soto et al, 2022;Bourguignon et al, 2021) respectivamente, de los cuales no se alejan de la media establecida en este estudio, por lo contrario,Wyndaele et al (2006), en su estudio indica 2.23% lo cual no se asemeja a artículos de este continente.En América se evidenció estudios donde la prevalencia oscilaba de la siguiente manera, en USA 51%(Sekine, et al, 2018), Brasil 22%(Tagliari et al, 2018), 35% (Da Costa et al, 2021 y 38%(Formentin et al, 2019), siendo estos resultados significativamente elevados en relación a datos publicados en un sitio web de Estados Unidos Spinal Cord Injury Information Pages el cual indica un 2.91. Los organismos encargados de salud no disponen de una prevalencia establecida, Organización Mundial de la Salud (World Health Organization [OMS], 2013) indica una incidencia anual 250.00 y 500.000 pero no son datos actualizados desde el año 2013, es…”