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.
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DOI：
10.1089/neu.2020.7144
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发表时间：
2021-03
影响因子：
4.2
通讯作者：
Wright K
中科院分区：
文献类型：
--
作者：
Harrington GMB;Cool P;Hulme C;Osman A;Chowdhury JR;Kumar N;Budithi S;Wright K
脊髓损伤（SCI）后的神经功能结局目前难以预测。虽然最初的美国脊髓损伤协会损伤量表（AIS）分级可以估计结果，但剩余的高度不确定性引发了最近对SCI生物标志物的兴趣。本研究旨在通过建立出院时和伤后12个月AIS评分的预后模型，评估常规测量的血液生物标志物的预后价值。从SCI患者（n = 417）中收集常规血液和临床数据，并排除在不到50%的患者中评估的血液指标。结果神经学获得AIS和脊髓独立性测量III（SCIM-III）评分在出院和12个月后受伤，运动（AIS）和感觉（AIS，触摸和针刺）的能力进行了单独评估。为所有结局指标创建了有和无弹性净惩罚的线性回归模型。与肝功能相关的血液指标，如丙氨酸转氨酶，被发现在出院时和受伤后12个月增加SCIM-III的预测值。此外，总血细胞计数的组成部分，包括血红蛋白，被发现在出院时和受伤后12个月增加AIS运动和感觉评分的预测值。这些发现证实了我们先前的初步研究结果，从而提供了进一步的证据，表明常规血液指标可以增加SCI的预后价值，肝功能标志物特别令人感兴趣。
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.
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