title: Validation of the Dutch clinical prediction rule for ambulation outcomes in an inpatient setting following traumatic spinal cord injury.
abstract: METHODS
  Retrospective study.
  
  
  OBJECTIVE
  To determine the accuracy of a previously described Dutch clinical prediction rule for ambulation outcome in routine clinical practice.
  
  
  METHODS
  Adult (⩾18 years) patients who were admitted to the Austin Hospital with a traumatic spinal cord injury between January 2006 and August 2014.
  
  
  METHODS
  Data from medical records were extracted to determine the score of the Dutch clinical ambulation prediction rule proposed by van Middendorp et al. in 2011. A receiver-operating characteristics (ROC) curve was generated to investigate the performance of the prediction rule. Univariate analyses were performed to investigate which factors significantly influence ambulation after a traumatic spinal cord injury.
  
  
  RESULTS
  The area under the ROC curve (AUC) obtained during the current study (0.939, 95% confidence interval (CI) (0.892, 0.986)) was not significantly different from the AUC from the original Dutch clinical prediction model (0.956, 95% CI (0.936, 0.976)). Factors that were found to have a significant influence on ambulation outcome were time spent in the ICU, number of days hospitalised and injury severity. Age at injury initially showed a significant influence on ambulation however, this effect was not apparent after inclusion of the 24 patients who died due to the trauma (and therefore did not walk after their injuries).
  
  
  CONCLUSIONS
  The Dutch ambulation prediction rule performed similarly in routine clinical practice as in the original, controlled study environment in which it was developed. The potential effect of survival bias in the original model requires further investigation.
authors.affiliation: Institute for Breathing and Sleep, Austin Health, Heidelberg, Melbourne, Victoria, Australia.|Victorian Spinal Cord Service, Austin Health, Heidelberg, Melbourne, Victoria, Australia.
authors.forename: L
authors.initials: L
authors.lastname: van Silfhout
authors.affiliation: Institute for Breathing and Sleep, Austin Health, Heidelberg, Melbourne, Victoria, Australia.|Victorian Spinal Cord Service, Austin Health, Heidelberg, Melbourne, Victoria, Australia.
authors.forename: A E J
authors.initials: AE
authors.lastname: Peters
authors.affiliation: Institute for Breathing and Sleep, Austin Health, Heidelberg, Melbourne, Victoria, Australia.
authors.forename: M
authors.initials: M
authors.lastname: Graco
authors.affiliation: Institute for Breathing and Sleep, Austin Health, Heidelberg, Melbourne, Victoria, Australia.
authors.forename: R
authors.initials: R
authors.lastname: Schembri
authors.affiliation: Victorian Spinal Cord Service, Austin Health, Heidelberg, Melbourne, Victoria, Australia.
authors.forename: A K
authors.initials: AK
authors.lastname: Nunn
authors.affiliation: Institute for Breathing and Sleep, Austin Health, Heidelberg, Melbourne, Victoria, Australia.
authors.forename: D J
authors.initials: DJ
authors.lastname: Berlowitz
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003661:Decision Support Techniques; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007297:Inpatients / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D012372:ROC Curve; D015203:Reproducibility of Results; D012189:Retrospective Studies; D013119:Spinal Cord Injuries / Q000503:physiopathology* / Q000534:rehabilitation*; D016138:Walking / Q000502:physiology*; D055815:Young Adult