Faculty Collaboration Database

Acute Adverse Events After Spinal Cord Injury and Their Relationship to Long-term Neurologic and Functional Outcomes: Analysis From the North American Clinical Trials Network for Spinal Cord Injury. Crit Care Med 2019 Nov;47(11):e854-e862

Date

08/08/2019

Pubmed ID

31389834

DOI

10.1097/CCM.0000000000003937

Scopus ID

2-s2.0-85073184828 (requires institutional sign-in at Scopus site)   16 Citations

Abstract

OBJECTIVES: There are few contemporary, prospective multicenter series on the spectrum of acute adverse events and their relationship to long-term outcomes after traumatic spinal cord injury. The goal of this study is to assess the prevalence of adverse events after traumatic spinal cord injury and to evaluate the effects on long-term clinical outcome.

DESIGN: Multicenter prospective registry.

SETTING: Consortium of 11 university-affiliated medical centers in the North American Clinical Trials Network.

PATIENTS: Eight-hundred one spinal cord injury patients enrolled by participating centers.

INTERVENTIONS: Appropriate spinal cord injury treatment at individual centers.

MEASUREMENTS AND MAIN RESULTS: A total of 2,303 adverse events were recorded for 502 patients (63%). Penalized maximum logistic regression models were fitted to estimate the likelihood of neurologic recovery (ASIA Impairment Scale improvement ≥ 1 grade point) and functional outcomes in subjects who developed adverse events at 6 months postinjury. After accounting for potential confounders, the group that developed adverse events showed less neurologic recovery (odds ratio, 0.55; 95% CI, 0.32-0.96) and was more likely to require assisted breathing (odds ratio, 6.55; 95% CI, 1.17-36.67); dependent ambulation (odds ratio, 7.38; 95% CI, 4.35-13.06) and have impaired bladder (odds ratio, 9.63; 95% CI, 5.19-17.87) or bowel function (odds ratio, 7.86; 95% CI, 4.31-14.32) measured using the Spinal Cord Independence Measure subscores.

CONCLUSIONS: Results from this contemporary series demonstrate that acute adverse events are common and are associated with worsened long-term outcomes after traumatic spinal cord injury.

Author List

Jiang F, Jaja BNR, Kurpad SN, Badhiwala JH, Aarabi B, Grossman RG, Harrop JS, Guest JD, Schär RT, Shaffrey CI, Boakye M, Toups EG, Wilson JR, Fehlings MG, North American Clinical Trials Network Collaborators

Author

Shekar N. Kurpad MD, PhD Chair, Director, Professor in the Neurosurgery department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Abbreviated Injury Scale
Adult
Depression
Female
Humans
Hypotension
Length of Stay
Male
Middle Aged
Mobility Limitation
North America
Pneumonia
Registries
Respiration, Artificial
Skin Ulcer
Spinal Cord Injuries
Suppositories
Urinary Bladder, Neurogenic
Urinary Catheterization