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Status: Bibliographieeintrag

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Verfasst von:Bock, Tobias [VerfasserIn]   i
 Heller, Raban [VerfasserIn]   i
 Haubruck, Patrick [VerfasserIn]   i
 Raven, Tim Friedrich [VerfasserIn]   i
 Pilz, Maximilian [VerfasserIn]   i
 Moghaddam-Alvandi, Arash [VerfasserIn]   i
 Biglari, Bahram [VerfasserIn]   i
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

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