title: Current practice of methylprednisolone administration for acute spinal cord injury in Germany: a national survey.
abstract: METHODS
  Written mail-out survey.
  
  
  OBJECTIVE
  To determine current practice in high-dose methylprednisolone succinate (MPSS) administration for treatment of acute spinal cord injury (SCI) in Germany.
  
  
  BACKGROUND
  Reanalysis of the National Acute Spinal Cord Injury Studies (NASCIS) resulted in criticism of the use of high-dose MPSS for treatment of acute SCI. Subsequently, SCI treatment guidelines were revised leading to a reduction in MPSS use across North America. The impact of these revisions on SCI treatment in Germany is not known.
  
  
  METHODS
  A questionnaire was sent to all trauma, orthopedic and neurosurgical departments of German university centers, affiliated teaching hospitals, and specialized SCI care centers. Survey included 6 questions about the administration of MPSS after acute SCI.
  
  
  RESULTS
  Three hundred seventy-two respondents completed the survey (response rate: 51% overall, 76% university hospitals, 85% specialized SCI care centers). Overall, 55% of departments that treat SCI prescribe MPSS. Among them, 73% are "frequent" users administering MPSS to more than 50% of their patients. Ten percent prescribe according to NASCIS I, 43% NASCIS II, 33% NASCIS III, and 13% "generic protocols." As justification for MPSS treatment, "effectiveness" ranked before "common practice" and "medicolegal reasons." "Specialized" SCI care centers differ in that (1) MPSS is administered less frequently, (2) NASCIS I doses are not used, and (3) during the past several years, practice patterns are more likely to have shifted away from the treatment of SCI with MPSS.
  
  
  CONCLUSIONS
  About one-half of the institutions continue to prescribe MPSS in the setting of acute SCI. A need for further education in almost one-fourth of German departments treating acute SCI is demonstrated through responses indicating use of the outdated NASCIS I protocol, a "legal need" or "unchanged MPSS application during the last years." "Specialized" SCI centers are more likely to change their practice in accordance with evolving literature.
  
  
  METHODS
  3.
authors: Clinical and Experimental Spinal Cord Injury Research Laboratory (Neuroparaplegiology), CHARITÉ Campus Mitte-University Medicine Berlin, Germany.
authors: Claudia
authors: C
authors: Druschel
authors: Klaus-Dieter
authors: KD
authors: Schaser
authors: Jan M
authors: JM
authors: Schwab
mesh_terms: D000208:Acute Disease; D005858:Germany; D019538:Health Care Surveys / Q000379:methods / Q000706:statistics & numerical data*; D006801:Humans; D008776:Methylprednisolone Hemisuccinate / Q000627:therapeutic use*; D018696:Neuroprotective Agents / Q000627:therapeutic use; D009656:North America; D013119:Spinal Cord Injuries / Q000188:drug therapy*; D011795:Surveys and Questionnaires
chemical_list: D018696:Neuroprotective Agents; D008776:Methylprednisolone Hemisuccinate