| Online-Ressource |
Verfasst von: | Bock, Tobias [VerfasserIn]  |
| Heller, Raban [VerfasserIn]  |
| Haubruck, Patrick [VerfasserIn]  |
| Raven, Tim Friedrich [VerfasserIn]  |
| Pilz, Maximilian [VerfasserIn]  |
| Moghaddam-Alvandi, Arash [VerfasserIn]  |
| Biglari, Bahram [VerfasserIn]  |
Titel: | Pursuing more aggressive timelines in the surgical treatment of traumatic spinal cord injury (TSCI) |
Titelzusatz: | a retrospective cohort study with subgroup analysis |
Verf.angabe: | Tobias Bock, Raban Arved Heller, Patrick Haubruck, Tim Friedrich Raven, Maximilian Pilz, Arash Moghaddam, Bahram Biglari |
E-Jahr: | 2021 |
Jahr: | 20 December 2021 |
Umfang: | 16 S. |
Fussnoten: | Gesehen am 24.06.2022 |
Titel Quelle: | Enthalten in: Journal of Clinical Medicine |
Ort Quelle: | Basel : MDPI, 2012 |
Jahr Quelle: | 2021 |
Band/Heft Quelle: | 10(2021), 24, Artikel-ID 5977, Seite 1-16 |
ISSN Quelle: | 2077-0383 |
Abstract: | Background: The optimal timing of surgical therapy for traumatic spinal cord injury (TSCI) remains unclear. The purpose of this study is to evaluate the impact of “ultra-early” (<4 h) versus “early” (4-24 h) time from injury to surgery in terms of the likelihood of neurologic recovery. Methods: The effect of surgery on neurological recovery was investigated by comparing the assessed initial and final values of the American Spinal Injury Association (ASIA) Impairment Scale (AIS). A post hoc analysis was performed to gain insight into different subgroup regeneration behaviors concerning neurological injury levels. Results: Datasets from 69 cases with traumatic spinal cord injury were analyzed. Overall, 19/46 (41.3%) patients of the “ultra-early” cohort saw neurological recovery compared to 5/23 (21.7%) patients from the “early” cohort (p = 0.112). The subgroup analysis revealed differences based on the neurological level of injury (NLI) of a patient. An optimal cutpoint for patients with a cervical lesion was estimated at 234 min. Regarding the prediction of neurological improvement, sensitivity was 90.9% with a specificity of 68.4%, resulting in an AUC (area under the curve) of 84.2%. In thoracically and lumbar injured cases, the estimate was lower, ranging from 284 (thoracic) to 245 min (lumbar) with an AUC of 51.6% and 54.3%. Conclusions: Treatment within 24 h after TSCI is associated with neurological recovery. Our hypothesis that intervention within 4 h is related to an improvement in the neurological outcome was not confirmed in our collective. In a clinical context, this suggests that after TSCI there is a time frame to get the right patient to the right hospital according to advanced trauma life support (ATLS) guidelines. |
DOI: | doi:10.3390/jcm10245977 |
URL: | Bitte beachten Sie: Dies ist ein Bibliographieeintrag. Ein Volltextzugriff für Mitglieder der Universität besteht hier nur, falls für die entsprechende Zeitschrift/den entsprechenden Sammelband ein Abonnement besteht oder es sich um einen OpenAccess-Titel handelt.
Volltext: https://doi.org/10.3390/jcm10245977 |
| Volltext: https://www.mdpi.com/2077-0383/10/24/5977 |
| DOI: https://doi.org/10.3390/jcm10245977 |
Datenträger: | Online-Ressource |
Sprache: | eng |
Sach-SW: | AIS |
| biomarker |
| decompressive surgery |
| laminectomy |
| neurological outcome |
| neurological recovery |
| timing |
| traumatic spinal cord injury |
K10plus-PPN: | 180775796X |
Verknüpfungen: | → Zeitschrift |
Pursuing more aggressive timelines in the surgical treatment of traumatic spinal cord injury (TSCI) / Bock, Tobias [VerfasserIn]; 20 December 2021 (Online-Ressource)