Dataset Information

Prediction of bowel management independence after ischemic spinal cord injury.

ABSTRACT:

Background

Ischemic spinal cord injury (SCI) belongs to the heterogeneous group of non-traumatic SCI, while the course of sensorimotor and functional recovery is comparable to traumatic SCI. Recently, we derived from data of patients with traumatic SCI a valid model to predict an independent and reliable bowel management one year after SCI.

Aim

To evaluate the performance of this model to predict an independent and reliable bowel management one year following ischemic SCI.

Design

Prognostic study - observational study.

Setting

European Multicenter Study about Spinal Cord Injury (EMSCI) ClinicalTrials.gov: NCT01571531.

Population

One hundred and forty-two patients with ischemic SCI of various level and severity of injury.

Methods

The prediction model relied on a single predictor collected within 40 days from injury, the International Standards for Neurological Classification of Spinal Cord Injury total motor score. Bowel outcome one year after SCI derived from the dichotomization of the Spinal Cord Independence Measure (SCIM) item 7 scores. We defined a positive outcome as independent bowel management with regular movements and appropriate timing with no or rare accidents (score of 10 in SCIM version II and score of 8 or 10 in version III).

Results

The model showed a fair discrimination with an area under the receiver operating characteristic (ROC) curve of 0.780 (95% confidence interval=0.702-0.860). In addition, the model displayed an acceptable accuracy and calibration.

Conclusions

The study extends the validity of our rule to patients with ischemic SCI, thus providing the first model to predict an independent and reliable bowel management in this population.

Clinical rehabilitation impact

The model may be employed in clinical practice to counsel patients, to define the rehabilitation aims and to estimate the need of assistance after discharge, as well as in the research field for the optimization of patients' allocation in the design of future clinical trials.

SUBMITTER: Pavese C

PROVIDER: S-EPMC10019474 | biostudies-literature | 2022 Oct

REPOSITORIES: biostudies-literature

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Publications

Prediction of bowel management independence after ischemic spinal cord injury.

Pavese Chiara C Scivoletto Giorgio G Puci Mariangela V MV Abel Rainer R Curt Armin A Maier Doris D Rupp Rüdiger R Schubert Martin M Weidner Norbert N Montomoli Cristina C Kessler Thomas M TM

European journal of physical and rehabilitation medicine 20220606 5

<h4>Background</h4>Ischemic spinal cord injury (SCI) belongs to the heterogeneous group of non-traumatic SCI, while the course of sensorimotor and functional recovery is comparable to traumatic SCI. Recently, we derived from data of patients with traumatic SCI a valid model to predict an independent and reliable bowel management one year after SCI.<h4>Aim</h4>To evaluate the performance of this model to predict an independent and reliable bowel management one year following ischemic SCI.<h4>Desi ...[more]

PMID: 35666490

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Project description:BackgroundSpinal cord ischemic injury is a severe complication of aortic surgery. We hypothesized that cerebrospinal fluid (CSF) oxygenation with nanobubbles after reperfusion could ameliorate spinal cord ischemic injury.MethodsTwenty white Japanese rabbits were categorized into 4 groups of 5 rabbits each: sham group, with balloon catheter insertion into the aorta; ischemia group, with spinal cord ischemic injury by abdominal aortic occlusion; nonoxygenated group, with nonoxygenated artificial CSF irrigation after spinal cord ischemic injury; and oxygenated group, with oxygenated artificial CSF irrigation after spinal cord ischemic injury. At 48 hours after spinal cord ischemic injury, the modified Tarlov score to reflect hind limb movement was evaluated. The spinal cord was histopathologically examined by counting anterior horn cells, and microarray and quantitative reverse-transcription polymerase chain reaction (qRT-PCR) analyses were performed.ResultsThe oxygenated group showed improved neurologic function compared with the ischemia and nonoxygenated groups (P < .01 and P = .019, respectively). Anterior horn neuron prevention in the sham, nonoxygenated, and oxygenated groups was confirmed (mean modified Tarlov score: sham, 9.2 ± 1.9; nonoxygenated, 10.2 ± 2.2; oxygenated, 10.4 ± 2.2; ischemia, 2.7 ± 2.7). Microarray analysis identified 644 genes with twofold or greater increased signals between the ischemia and sham groups. Thirty-three genes related to inflammatory response were enriched among genes differentially expressed between the oxygenated and ischemia groups. Interleukin (IL)-6 and tumor necrosis factor (TNF) expression levels were significantly lower in the oxygenated group compared with the ischemia group, while qRT-PCR showed lower IL-6 and TNF expression levels in the oxygenated group compared with the ischemia group (P < .05).ConclusionsCSF oxygenation with nanobubbles after reperfusion can ameliorate spinal cord ischemic injury and suppress inflammatory responses in the spinal cord.

Dataset Information

Prediction of bowel management independence after ischemic spinal cord injury.

Background

Aim

Design

Setting

Population

Methods

Results

Conclusions

Clinical rehabilitation impact

Publications

Prediction of bowel management independence after ischemic spinal cord injury.

Similar Datasets

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