Evaluating associations between trauma-related characteristics and functional recovery in individuals with spinal cord injury

评估脊髓损伤患者的创伤相关特征与功能恢复之间的关联

• 批准号: 9902845
• 负责人: Shivayogi V Hiremath
• 金额: $ 16.89万
• 依托单位: TEMPLE UNIV OF THE COMMONWEALTH
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-08-04 至 2022-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9902845
• 关键词: Acute; Address; Admission activity; Age; Area; Biological Models; Caring; Characteristics; Clinical; Clinical Data; Communities; Continuity of Patient Care; Data; Database Management Systems; Databases; Event; Funding Opportunities; Glasgow Coma Scale; Goals; Grant; Growth; Health Services; Health Services Research; Health system; Hospitals; Individual; Injury; Inpatients; Intervention; Knowledge; Length of Stay; Link; Locomotion; Machine Learning; Mentors; Methods; Modeling; Motor; Outcome; Outcome Measure; Outcome Study; Patients; Pennsylvania; Phase; Physicians; Positioning Attribute; Process; Recovery of Function; Rehabilitation Outcome; Rehabilitation therapy; Reporting; Research; Research Personnel; Spinal cord injury; System; Time; Trauma; Work; World Health Organization; acute care; advanced analytics; analytical method; base; care outcomes; clinical decision-making; community living; feeding; functional adaptation; functional improvement; functional outcomes; functional status; improved; insight; longitudinal analysis; machine learning method; neurological recovery; novel; physical therapist; programs; trauma care

Project Summary World Health Organization established that every year, around the world, between 250,000 and 500,000 people suffer a spinal cord injury (SCI). While existing research suggests links between the injury event, early care, and rehabilitation outcomes, there still remains a critical knowledge gap – about how characteristics associated with trauma and acute phases of SCI can allow us to better understand functional recovery post- SCI. In the past, this research was partly hampered due to databases that either focused on trauma-care or inpatient rehabilitation. However, using advanced analytical methods, we are now in a position to combine databases that contain trauma and acute phase-related variables with patient-level characteristics to assess longitudinal functional recovery over time. Trauma and acute phase-related variables include type of trauma, cause of injury, process of care, clinical data, and outcome data during acute care. The overall objective of this study is to use trauma and acute phase-related variables to explain the longitudinal functional recovery of individuals with SCI, from acute to post-acute to community. This will be achieved by probabilistically linking the Pennsylvania Trauma Systems Outcomes Study (PTOS) database with the National Spinal Cord Injury Model Systems (SCIMS) database. The PTOS and SCIMS databases provide complimentary information about trauma and acute phases of SCI from acute hospital to inpatient rehabilitation facility (IRF) to community. The long-term goal of our research is to identify trauma and acute phase-related variables that can be utilized during acute care and post-acute rehabilitation interventions to improve clinical decision making, which in turn enhances rehabilitation programs.The central hypothesis of this proposal is that trauma and acute phase- related variables, combined with patient-level characteristics, will significantly predict longitudinal functional recovery in individuals post-SCI. Our hypothesis is guided by prior research and our pilot work with the PTOS database. A primary objective of this proposal is to examine the association between trauma and acute phase- related variables with functional improvements during IRF in individuals with traumatic SCI using machine learning ensemble methods (Aim 1). A secondary objective of this study is to develop longitudinal trajectories of functional recovery over a period of 1-year post-SCI taking into account trauma, acute phase, and patient- level characteristics during acute, post-acute, and community living using growth curve modelling (Aim 2). The proposed study will yield novel insights about the relationship between trauma and acute phase-related variables with functional status.

项目概要 世界卫生组织确定，全世界每年有 250,000 至 500,000 人们遭受脊髓损伤 (SCI)。虽然现有研究表明伤害事件之间存在联系，但早期 护理和康复结果方面，仍然存在一个关键的知识差距——关于特征如何 与创伤和 SCI 急性期相关可以让我们更好地了解术后功能恢复 SCI。过去，这项研究在一定程度上受到了阻碍，因为数据库要么专注于创伤护理，要么专注于创伤护理。 住院康复。然而，通过使用先进的分析方法，我们现在能够将 包含创伤和急性期相关变量以及患者水平特征的数据库以进行评估 随着时间的推移纵向功能恢复。创伤和急性期相关变量包括创伤类型、 受伤原因、护理过程、临床数据和急性护理期间的结果数据。本次活动的总体目标 研究的目的是利用创伤和急性期相关变量来解释纵向功能恢复 SCI 患者，从急性到急性后到社区。这将通过概率链接来实现 宾夕法尼亚州创伤系统结果研究 (PTOS) 数据库与国家脊髓损伤 模型系统 (SCIMS) 数据库。 PTOS 和 SCIMS 数据库提供免费信息 关于从急性医院到住院康复机构 (IRF) 再到社区的 SCI 创伤和急性阶段。 我们研究的长期目标是确定可以利用的创伤和急性期相关变量 在急性护理和急性后康复干预期间，以改善临床决策，进而 加强康复计划。该提案的中心假设是创伤和急性期 相关变量与患者水平特征相结合，将显着预测纵向功能 SCI 后个体的康复。我们的假设以先前的研究和我们与 PTOS 的试点工作为指导 数据库。该提案的主要目的是检查创伤和急性期之间的关联 创伤性 SCI 患者使用机器进行 IRF 期间功能改善的相关变量 学习集成方法（目标 1）。这项研究的第二个目标是开发纵向轨迹 考虑到创伤、急性期和患者的情况，SCI 后 1 年的功能恢复情况 使用生长曲线模型（目标 2）确定急性期、急性期后和社区生活期间的水平特征。这 拟议的研究将对创伤与急性期相关之间的关系产生新的见解 具有功能状态的变量。