A prediction model of functional outcome at 6 months using clinical findings of a person with traumatic spinal cord injury at 1 month after injury
A prediction model of functional outcome at 6 months using clinical findings of a person with traumatic spinal cord injury at 1 month after injury
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DOI：
10.1038/s41393-020-0488-5
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发表时间：
2020-05-22
期刊：
影响因子：
2.2
通讯作者：
Maeda, Takeshi
中科院分区：
文献类型：
--
作者：
Ariji, Yuto;Hayashi, Tetsuo;Maeda, Takeshi
研究设计数据库的回顾性统计分析。目的根据伤后1个月的体格检查结果预测伤后6个月的脊髓独立性量表第三版总评分（SCIM-TS），是指导恢复期康复治疗的重要指标。设置日本福冈脊柱损伤中心。方法研究对象选自日本脊髓损伤中心脊柱和脊髓损伤专业的日本脊髓损伤单中心研究数据库（JSSCI-DB）中登记的创伤性脊髓损伤患者。在2012年1月至2018年10月期间在JSSCI-DB注册的534名参与者中，我们回顾性地提取了137名受伤后6个月的参与者，这些参与者被纳入本研究。结果根据多元回归分析，仅根据6个变量即可预测伤后6个月SCIM-TS，受伤时的年龄、三块关键肌肉（C6腕伸肌、C8指屈肌和L3膝伸肌）和两项活动性评估（WISCI和SCIM-项目13）（调整后的R平方：0.83）。这6个自变量是反映6个月SCIM-TS的显著因素。结论在脊髓损伤后康复治疗中，简单可靠的预测模型能准确预测患者日常生活活动能力的可达性，从而为患者制定目标提供依据。此外，如果程序简单，可以在短时间内完成评估，并且可以减轻治疗人员和患者的身体负担。
Study design Retrospective statistical analysis of database. Objectives Prediction of the Spinal Cord Independence Measure version III Total Score (SCIM-TS) at 6 months after injury based on physical findings at 1 month after injury is an important index for rehabilitation approach in the recovery phase. Setting Spinal Injuries Center, Fukuoka, Japan. Methods The study participants were selected from patients with traumatic spinal cord injuries who were registered in the Japan Single Center Study for Spinal Cord Injury Data Base (JSSCI-DB) of the Japan Spinal Injuries Center specializing in spine and spinal cord injuries. Of the 534 participants registered with the JSSCI-DB between January 2012 and October 2018, we retrospectively extracted 137 participants for 6 months after injury, and these participants were included in this study. Results According to multiple regression analysis, SCIM-TS at 6 months after injury could be predicted based on only six variables, i.e., age at injury, three key muscles (C6 wrist extensors, C8 finger flexors, and L3 knee extensors), and two mobility assessments (WISCI and SCIM-item13) (Adjusted R-Squared: 0.83). These six independent variables were significant factors reflecting SCIM-TS at 6 months. Conclusions In rehabilitation after traumatic spinal cord injuries, a simple and reliable prognostic model can help accurately predict the achievable activity of daily living competency to set a goal. In addition, if the procedure is simple, evaluation can be completed in a short period of time, and the physical burden on both treating staff and patients can be reduced.