title: 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.
authors.affiliation: 1 Service d'orthopédie et de traumatologie de l'appareil locomoteur, Cliniques universitaires Saint-Luc , Brussels, Belgium .
authors.forename: Ludovic
authors.initials: L
authors.lastname: Kaminski
authors.affiliation: 2 Computer Assisted and Robotic Surgery (CARS), Institut de recherche expérimentale et clinique, Université catholique de Louvain , Brussels, Belgium .
authors.forename: Virginie
authors.initials: V
authors.lastname: Cordemans
authors.affiliation: 3 Central Military University Hospital "Dr. Carol Davila ," Bucharest, Romania .
authors.forename: Eduard
authors.initials: E
authors.lastname: Cernat
authors.affiliation: 4 Service d'orthopédie et de traumatologie, Centre Hospitalier Universitaire (CHU) , Bouaké, Bouaké, Ivory Coast.
authors.forename: Kouamé Innocent
authors.initials: KI
authors.lastname: M'Bra
authors.affiliation: 5 Department of Surgery, Faculty of Medicine, University of Montreal , Montreal, Quebec, Canada .|6 Department of Surgery, Hôpital du Sacré-cœur de Montréal , Montreal, Quebec, Canada .
authors.forename: Jean-Marc
authors.initials: JM
authors.lastname: Mac-Thiong
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care / Q000379:methods*; D011379:Prognosis; D013119:Spinal Cord Injuries / Q000175:diagnosis* / Q000503:physiopathology / Q000628:therapy*; D014193:Trauma Centers / Q000706:statistics & numerical data; D055815:Young Adult
keywords: ASIA impairment scale; clinical prediction model; functional outcome; spinal cord injury