Consequences of high-dose steroid therapy for acute spinal cord injury
Consequences of high-dose steroid therapy for acute spinal cord injury
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DOI：
10.1097/00005373-199702000-00017
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发表时间：
1997-02-01
影响因子：
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通讯作者：
Papadopoulos, SM
中科院分区：
文献类型：
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作者：
Gerndt, SJ;Rodriguez, JL;Papadopoulos, SM
目的：高剂量甲强龙（Upjohn，Kalamazoo，Mich）疗法已成为急性脊髓损伤（ASCI）治疗的标准护理，本研究试图确定Solu-Medrol疗法对这些患者的不良反应。设计：历史对照回顾性研究。材料和方法：从1990年5月至1994年4月，根据国家急性脊髓损伤研究，所有在损伤后8小时内入院的ASCI患者均接受了高剂量的甲强龙（NASCIS-2）方案，将他们的人口统计学和结局参数与1986年3月至1993年12月收治的未接受类固醇治疗的相关ASCI患者组进行比较。测量和主要结果：类固醇治疗与肺炎发病率增加2.6倍以及通气和重症监护天数增加相关，但与康复时间缩短相关，对其他结局参数（包括死亡率）无显著影响。结论：尽管NASCIS-2方案可能促进早期感染并发症，但对ASCI患者的长期结局无不良影响。
Objective: High-dose Solu-Medrol (Upjohn, Kalamazoo, Mich) therapy has become standard care in the management of acute spinal cord injury (ASCI), This study attempts to define the adverse effects that Solu-Medrol therapy has on these patients.Design: Retrospective review with historical control.Material and Methods: From May 1990 to April 1994, all patients with ASCI admitted within 8 hours of injury received high-dose Solu-Medrol per the National Acute Spinal Injury Study (NASCIS-2) protocol, Their demographic and outcome parameters were compared with those of a group admitted from March 1986 to December 1993 with an associated ASCI who received no steroid therapy.Measurements and Main Results: Steroid therapy was associated with a 2.6-fold increase in the incidence of pneumonia and an increase in ventilated and intensive care days, However, it was associated with a decrease in duration of rehabilitation and had no significant impact on other outcome parameters, including mortality.Conclusions: Although the NASCIS-2 protocol may promote early infectious complications, it has no adverse impact on longterm outcome in patients with ASCIs.