Clinical Predictors of Neurological Outcome within 72 h after Traumatic Cervical Spinal Cord Injury

Qiu, Zhi; Wang, Fangyong; Ye, Hong; Zhang, Junwei; Tang, He-Hu; Li, Xiang; Jiang, Steven; Lv, Zhenyu; Liu, Shujia; Chen, Shizheng; Liu, Jie‐Sheng

doi:10.1038/srep38909

Cited by 17 publications

(18 citation statements)

References 24 publications

(29 reference statements)

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“…It was recognized that either primary or secondary injury was associated with the outcome of tSCI patients was considered to be [ 4 , 5 ], and several standard prognostic factors at admission, including age, blood cells counts, coagulation status, Charleson Co-morbidity Index (CCI), American spinal injury association Impairment Scale (AIS) grades, and the initial Glasgow Coma Scale (GCS) score, were identified to be associated with the outcome of tSCI patients [ 6 , 7 ]; however, their prognostic values were limited even a variety of predictive models were built. Thus, to develop a model with higher prognostic value is justified.…”

Section: Introductionmentioning

confidence: 99%

Circulating neutrophil-to-lymphocyte ratio at admission predicts the long-term outcome in acute traumatic cervical spinal cord injury patients

Zhao

Lai

et al. 2020

BMC Musculoskelet Disord

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Background: The prognostic value of Neutrophil-to-Lymphocyte Ratio (NLR) for the outcome of acute cervical traumatic spinal cord injury (tSCI) patients has rarely been studied by now throughout the world. Methods: We performed a single-center retrospective cohort study to evaluate the prognostic value of NLR from peripheral whole blood count in patients with acute cervical tSCI. Patients within 6 h of acute cervical tSCI treated between Dec 2008 and May 2018 in Huashan Hospital of Fudan University were enrolled. Outcomes of patients with tSCI were assessed using American spinal injury association Impairment Scale (AIS). 6-month outcomes were dichotomized into poor outcome group (AIS A to C) and good outcome group (AIS D and E). Uni-and multivariate analyses were performed to assess the independent predictors of 6-month outcome. Two prediction models based on admission characteristics were built to evaluate the prognostic value of NLR. The discriminative ability of predictive models was evaluated using the area under the curve (AUC). Results: A total of 377 patients were identified from our single center in China PR. Multivariate analysis showed that age, AIS grade at admission, NLR (p < 0.001) and coagulopathy (p = 0.003) were independent predictors of the 6-months outcome for acute cervical tSCI patients. The model combing NLR and standard variables (AUC = 0.944; 95% CI, 0.923-0.964) showed a more favorable prognostic value than that without NLR (AUC = 0.841; 95% CI, 0.798-0.885) in terms of 6-month outcome. Conclusions: NLR is firstly identified as an independent predictor of the 6-month outcome in acute cervical tSCI patients worldwide. The prognostic value of NLR is favorable, and a high NLR is associated with poor outcome in patients with acute cervical tSCI.

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Section: Introductionmentioning

confidence: 99%

Circulating neutrophil-to-lymphocyte ratio at admission predicts the long-term outcome in acute traumatic cervical spinal cord injury patients

Zhao

Lai

et al. 2020

BMC Musculoskelet Disord

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“…Qiu et al . [18] showed that all the cases with cord transection showed complete SCIs without neurological recovery. Cord transection should be the best predictors for complete SCI.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of traumatic spine by magnetic resonance imaging and its correlation with cliniconeurological outcome

Naik

Sakalecha

Savagave

2019

J Emerg Trauma Shock

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Background: Spinal trauma is associated with long-term disability. Early detection can lead to prompt and accurate diagnosis, expeditious management, and avoidance of unnecessary procedures. Magnetic resonance imaging (MRI) helps to accurately depict the presence and extent of spinal cord injury (SCI) in these patients. Purpose: This study was aimed to look for various MRI findings which are predictive of initial neurological deficit in patients with spinal trauma and to correlate the findings with resultant neurological outcome. Materials and Methods: The present study was conducted over a period of 18 months from January 2016 to June 2017 in 57 patients with spinal trauma who underwent MRI spine. Neurological status of patients was assessed at the time of admission and discharge in accordance with the American Spine Injury Association (ASIA) impairment scale. Various MRI parameters were evaluated for correlation with the severity of the spinal injury. Results: Patients with cord transection, cord hemorrhage, and epidural hematoma had initial high-grade ASIA impairment scale. Patients with cord transection and cord hemorrhage did not show any improvement in their neurological status during their hospital stay. Patients with only cord edema and epidural hematoma showed favorable neurological outcome. Cord contusion showed lesser neurological recovery, as compared with cord edema and normal cord. Conclusion: MRI findings in acute SCI correlated well with the initial neurological deficits on admission and at the time of discharge. MRI should be recommended in all patients with suspected spinal trauma both as a diagnostic and prognostic indicator.

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“…On sagittal T 2 images, normal cord shows no signal abnormalities and oedema shows high signal intensity, while acute haemorrhage elicits hypointense signal with a thin rim of high signal intensity. 5…”

Section: Learning Pointsmentioning

confidence: 99%

“…Contusion shows normal images on T 1 WI, while the spinal cord on T 2 WI elicits a small central area of abnormal signal intensity. 5…”

Section: Learning Pointsmentioning

confidence: 99%

Traumatic cervical spinal cord transection

Mostafa¹

2019

BJR|case reports

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Clinical Predictors of Neurological Outcome within 72 h after Traumatic Cervical Spinal Cord Injury

Cited by 17 publications

References 24 publications

Circulating neutrophil-to-lymphocyte ratio at admission predicts the long-term outcome in acute traumatic cervical spinal cord injury patients

Circulating neutrophil-to-lymphocyte ratio at admission predicts the long-term outcome in acute traumatic cervical spinal cord injury patients

Evaluation of traumatic spine by magnetic resonance imaging and its correlation with cliniconeurological outcome

Traumatic cervical spinal cord transection

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