title: [Assessment of neurologic function and complications in a retrospective cohort of patients with acute spinal cord injury due to trauma treated with large-dose methylprednisolone].
abstract: OBJECTIVE
  Methylprednisolone was used to improve neurologic recovery from spinal cord injury in the National Acute Spinal Cord Injury Studies (NASCIS). Debate over this use led to further research and a 2002 report stating that there was insufficient evidence to support this application as a standard therapy. Our aim was to retrospectively assess this application in a cohort of patients with spinal cord injury.
  
  
  METHODS
  Retrospective cohort study of patients admitted to the intensive care unit (ICU) between 1997 and 2007 with a diagnosis of spinal cord injury due to trauma. The patients were grouped according to medical treatment received into a methylprednisolone group and a no-methylprednisolone group. We assessed change in neurologic function on the impairment scale of the American Spinal Injury Association on ICU admission and on discharge. We also recorded medical complications in each group. Cox multiple regression analysis was used to analyze differences between treatments.
  
  
  RESULTS
  No significant differences were detected in neurologic outcome on discharge from the ICU (odds ratio [OR], 1.57; 95% confidence interval [CI], 0.69-3.54). The methylprednisolone-treated patients had more medical complications such as hyperglycemia (OR, 5.67; 95% CI, 1.85-17.31) or gastrointestinal bleeding (OR, 19.16; 95% CI, 1.64-223.30) than the patients who did not receive methylprednisolone.
  
  
  CONCLUSIONS
  In this retrospective study, methylprednisolone was unrelated to improvement in neurologic outcome after acute spinal cord injury on ICU discharge although the patients treated with this drug were at greater risk of metabolic complications.
authors.affiliation: Servicio de Anestesiología y Reanimación, Hospital de Coslada, Madrid.
authors.forename: M
authors.initials: M
authors.lastname: Aomar Millán
authors.forename: M
authors.initials: M
authors.lastname: Cortiñas Sáenz
authors.forename: J
authors.initials: J
authors.lastname: Delgado Tapia
authors.forename: M
authors.initials: M
authors.lastname: Gerónimo Pardo
authors.forename: V
authors.initials: V
authors.lastname: Calatayud Pérez
authors.forename: R
authors.initials: R
authors.lastname: Peyró García
mesh_terms: D000328:Adult; D015331:Cohort Studies; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage* / Q000009:adverse effects; D006801:Humans; D008297:Male; D008775:Methylprednisolone / Q000008:administration & dosage* / Q000009:adverse effects; D012189:Retrospective Studies; D013119:Spinal Cord Injuries / Q000188:drug therapy* / Q000503:physiopathology
chemical_list: D005938:Glucocorticoids; D008775:Methylprednisolone