Questionnaire survey of spine surgeons on the use of methylprednisolone for acute spinal cord injury
Questionnaire survey of spine surgeons on the use of methylprednisolone for acute spinal cord injury
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DOI：
10.1097/01.brs.0000214886.21265.8c
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发表时间：
2006-04-20
期刊：
影响因子：
3
通讯作者：
Hodges, SD
中科院分区：
文献类型：
--
作者：
Eck, JC;Nachtigall, D;Hodges, SD
研究设计。问卷调查。目的。估计脊髓损伤 (SCI) 患者的类固醇方案的使用和合理性。背景数据摘要。关于类固醇治疗方案对 SCI 患者的临床益处和潜在并发症仍存在重大争议。方法。向脊柱外科医生发送了一项调查，要求提供以下信息：1) 专业化，2) 创伤中心隶属关系，3) 类固醇方案的使用，4) 使用类固醇方案的合理性，以及 5) SCI 体积。收到了 305 名外科医生的回复。 14 名 (4.6%) 外科医生仅在会诊前开始使用类固醇，262 名 (85.9%) 名外科医生会在接受的 8 小时时间范围内开始使用类固醇，20 名 (6.6%) 根本不使用类固醇，9 名 (3.0%) 使用不同的方案。使用类固醇的理由：65 名改善康复，64 名机构协议，110 名法医学原因，26 名个人没有开始使用类固醇。 18 名外科医生列出了临床获益和机构方案，另外 22 名外科医生列出了机构方案和法医学原因。结论。大多数（90.5%）有反应的外科医生使用类固醇方案；然而，由于相信可以改善临床结果，只有 24.1% 的人使用类固醇方案。
Study Design. A questionnaire survey.Objective. Estimate the use and justification of the steroid protocol for spinal cord injury (SCI) patients.Summary of Background Data. There remains significant debate over clinical benefits and potential complications of the steroid protocol for SCI patients.Methods. A survey was sent to spine surgeons requesting information on 1) specialization, 2) trauma center affiliation, 3) use of steroid protocol, 4) justification of using steroid protocol, and 5) SCI volume.Results. Responses were received from 305 surgeons. Fourteen (4.6%) surgeons used steroids only if initiated before their consult, 262 (85.9%) would initiate if within the accepted 8-hour timeframe, 20 (6.6%) did not use steroids at all, and 9 (3.0%) used a different protocol. Justification for steroids use: 65 improved recovery, 64 institutional protocol, 110 medicolegal reasons, and 26 did not personally initiate steroids. Eighteen surgeons listed both clinical benefit and institutional protocol, and 22 others listed both institutional protocol and medicolegal reasons.Conclusions. The majority (90.5%) of responding surgeons used the steroid protocol; however, only 24.1% used the steroid protocol due to a belief in improved clinical outcomes.