Serum Albumin Predicts Long-Term Neurological Outcomes After Acute Spinal Cord Injury

Tong, Bobo; Jutzeler, Catherine R.; Cragg, Jacquelyn J.; Grassner, Lukas; Schwab, Jan M.; Casha, Steve; Geisler, Fred H.; Kramer, John L.K.

doi:10.1177/1545968317746781

Cited by 33 publications

(31 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Serum albumin also has been previously found to be significantly predictive of AIS grade improvement up to 52 weeks. 66 Platelets and gender also were only retained in models of SCIM. Previous studies contradict this result and have suggested that gender does not significantly correlate with functional neurology or independence.…”

Section: Discussionmentioning

confidence: 99%

Routinely Measured Hematological Markers Can Help to Predict American Spinal Injury Association Impairment Scale Scores after Spinal Cord Injury

Harrington

Cool

Hulme

et al. 2021

Journal of Neurotrauma

View full text Add to dashboard Cite

Neurological outcomes following spinal cord injury (SCI) are currently difficult to predict. While the initial American Spinal Injury Association Impairment Scale (AIS) grade can give an estimate of outcome, the high remaining degree of uncertainty has stoked recent interest in biomarkers for SCI. This study aimed to assess the prognostic value of routinely measured blood biomarkers by developing prognostic models of AIS scores at discharge and 12 months post-injury. Routine blood and clinical data were collected from SCI patients ( n = 417), and blood measures that had been assessed in less than 50% of patients were excluded. Outcome neurology was obtained from AIS and Spinal Cord Independence Measure III (SCIM-III) scores at discharge and 12 months post-injury, with motor (AIS) and sensory (AIS, touch and prick) abilities being assessed individually. Linear regression models with and without elastic net penalization were created for all outcome measures. Blood measures associated with liver function, such as alanine transaminase, were found to add value to predictions of SCIM-III at discharge and 12 months post-injury. Further, components of a total blood count, including hemoglobin, were found to add value to predictions of AIS motor and sensory scores at discharge and 12 months post-injury. These findings corroborate the results of our previous preliminary study and thus provide further evidence that routine blood measures can add prognostic value in SCI and that markers of liver function are of particular interest.

show abstract

Section: Discussionmentioning

confidence: 99%

Routinely Measured Hematological Markers Can Help to Predict American Spinal Injury Association Impairment Scale Scores after Spinal Cord Injury

Harrington

Cool

Hulme

et al. 2021

Journal of Neurotrauma

View full text Add to dashboard Cite

show abstract

“…6 Based on these papers, we can conclude that the use of biomarkers on blood and cerebrospinal fluid (CSF) to predict neurological injury and severity remains on translational research since a specific array of biomarkers needs to be designed and tested before widespread clinical use. [7][8][9][10][11] Since the initial review on assessment tools for acute SCI was presented by Hadley et al 12 in 2002, the ASIA Impairment Scale (AIS, short form for ASIA International Standards for Neurological Classification of Spinal Cord Injury [ISNCSCI]) has been designated as the recommended evaluation tool to evaluate and classify initial neurological impairment on admission and provide information on improvement at follow-up. The AIS comprises 5 grades of neurological injury: grade A, complete neurological injury (no motor or sensory function at S4, S5 segment); grade B, no motor function but preserved sensory function below the neurological injury with preservation including S3 and S4; grade C, incomplete neurological injury (with the preserved motor function below the neurological levhttps://doi.org/10.14245/ns.2040366.183…”

Section: Clinical Assessment and Classification Of Scimentioning

confidence: 99%

Early Management of Spinal Cord Injury: WFNS Spine Committee Recommendations

et al. 2020

View full text Add to dashboard Cite

“…26 Therefore, our observed correlation between potassium and total motor score at 3 months is not unexpected. In a previous study involving 591 SCI patients, albumin was suggested to be an independent marker of long-term neurological outcome, 27 which may explain the correlation with 3 month outcome measures (except for pain scores). Other literature has also found notable alterations to RBC, hemoglobin, and hematocrit values in non-traumatic SCI, and has found that lymphocytes decreased over time in traumatic SCI.…”

mentioning

confidence: 98%

A Preliminary Cohort Study Assessing Routine Blood Analyte Levels and Neurological Outcome after Spinal Cord Injury

Brown

Harrington

Hulme

et al. 2020

Journal of Neurotrauma

View full text Add to dashboard Cite

There is increasing interest in the identification of biomarkers that could predict neurological outcome following a spinal cord injury (SCI). Although initial American Spinal Injury Association (ASIA) Impairment Scale (AIS) grade is a good indicator of neurological outcome, for the patient and clinicians, an element of uncertainty remains. This preliminary study aimed to assess the additive potential of routine blood analytes following principal component analysis (PCA) to develop prognostic models for neurological outcome following SCI. Routine blood and clinical data were collected from SCI patients (n = 82) and PCA used to reduce the number of blood analytes into related factors. Outcome neurology was obtained from AIS scores at 3 and 12 months post-injury, with motor (AIS and total including all myotomes) and sensory (AIS, touch and pain) abilities being assessed individually. Multiple regression models were created for all outcome measures. Blood analytes relating to ''liver function'' and ''acute inflammation and liver function'' factors were found to significantly increase prediction of neurological outcome at both 3 months (touch, pain, and AIS sensory) and at 1 year (pain, R 2 increased by 0.025 and total motor, R 2 increased by 0.016). For some models ''liver function'' and ''acute inflammation and liver function'' factors were both significantly predictive, with the greatest combined R 2 improvement of 0.043 occurring for 3 month pain prediction. These preliminary findings support ongoing research into the use of routine blood analytes in the prediction of neurological outcome in SCI patients.

show abstract

Serum Albumin Predicts Long-Term Neurological Outcomes After Acute Spinal Cord Injury

Abstract: In spinal cord injury, serum albumin is an independent marker of long-term neurological outcomes. Serum albumin could serve as a feasible biomarker for prognosis at the time of injury and stratification in clinical trials.

Cited by 33 publications

References 22 publications

Routinely Measured Hematological Markers Can Help to Predict American Spinal Injury Association Impairment Scale Scores after Spinal Cord Injury

Routinely Measured Hematological Markers Can Help to Predict American Spinal Injury Association Impairment Scale Scores after Spinal Cord Injury

Early Management of Spinal Cord Injury: WFNS Spine Committee Recommendations

A Preliminary Cohort Study Assessing Routine Blood Analyte Levels and Neurological Outcome after Spinal Cord Injury

Contact Info

Product

Resources

About