PMID- 34936887
OWN - NLM
STAT- MEDLINE
DCOM- 20220405
LR  - 20220511
IS  - 1532-821X (Electronic)
IS  - 0003-9993 (Linking)
VI  - 103
IP  - 4
DP  - 2022 Apr
TI  - Trauma Indicators in Spinal Cord Injury Rehabilitation Outcomes: A Retrospective 
      Cohort Analysis of the National Trauma Data Bank and National Spinal Cord Injury 
      Database.
PG  - 642-648.e2
LID - S0003-9993(21)01727-5 [pii]
LID - 10.1016/j.apmr.2021.12.001 [doi]
AB  - OBJECTIVE: To investigate whether initial emergency department physiological 
      measures and metrics of trauma severity predict functional outcomes and 
      neurologic recovery in traumatic spinal cord injury. DESIGN: Retrospective 
      analysis of a clinical database. SETTING: Merged multicenter data from the Spinal 
      Cord Injury Model Systems (SCIMS) database and National Trauma Data Bank from 6 
      academic medical centers across the United States. PARTICIPANTS: Patients (N=319) 
      admitted to SCIMS rehabilitation centers within 1 year of injury. The majority of 
      patients were men (76.2%), with a mean age of 44 years (SD, 19y). At 
      rehabilitation admission, the most common neurologic level of injury was low 
      cervical (C5-C8, 39.5%) and ASIA impairment scale (AIS) was A (34.4%). MAIN 
      OUTCOME MEASURES: Primary outcomes were FIM motor score at discharge from 
      inpatient rehabilitation and change in FIM motor score between inpatient 
      rehabilitation admission and discharge. We hypothesized that derangements in 
      emergency department physiological measures, such as decreased blood pressure and 
      oxygen saturation, as well as increased severity of trauma burden, would predict 
      poorer functional outcomes. RESULTS: Linear regression analysis showed that 
      neurologic level of injury and AIS predicted discharge FIM motor score. Systolic 
      blood pressure, heart rate, oxygen saturation, need for assisted respiration, and 
      presence of penetrating injury did not predict discharge motor FIM or FIM motor 
      score improvement. CONCLUSIONS: Initial emergency department physiological 
      parameters did not prognosticate functional outcomes in this cohort.
CI  - Copyright (c) 2021 The American Congress of Rehabilitation Medicine. Published by 
      Elsevier Inc. All rights reserved.
FAU - Shea, Cristina
AU  - Shea C
AD  - Department of Physical Medicine and Rehabilitation, Harvard Medical School, 
      Boston, MA; Spaulding Rehabilitation Hospital, Charlestown, MA.
FAU - Slocum, Chloe
AU  - Slocum C
AD  - Department of Physical Medicine and Rehabilitation, Harvard Medical School, 
      Boston, MA; Spaulding Rehabilitation Hospital, Charlestown, MA. Electronic 
      address: css129@mail.harvard.edu.
FAU - Goldstein, Richard
AU  - Goldstein R
AD  - Department of Physical Medicine and Rehabilitation, Harvard Medical School, 
      Boston, MA; Spaulding Rehabilitation Hospital, Charlestown, MA.
FAU - Roach, Mary Joan
AU  - Roach MJ
AD  - Case Western Reserve University School of Medicine, Cleveland, OH; MetroHealth 
      Rehabilitation Institute, Cleveland, OH; Center for Health Research and Policy, 
      Cleveland, OH.
FAU - Griffin, Russell
AU  - Griffin R
AD  - Trauma Care Delivery Research Unit, Department of Epidemiology, University of 
      Alabama at Birmingham, Birmingham, AL; University of Alabama at Birmingham School 
      of Public Health, Birmingham, AL.
FAU - Chen, Yuying
AU  - Chen Y
AD  - Department of Physical Medicine and Rehabilitation, University of Alabama at 
      Birmingham, Birmingham.
FAU - Zafonte, Ross
AU  - Zafonte R
AD  - Department of Physical Medicine and Rehabilitation, Harvard Medical School, 
      Boston, MA; Spaulding Rehabilitation Hospital, Charlestown, MA.
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
PT  - Research Support, U.S. Gov't, Non-P.H.S.
DEP - 20211220
PL  - United States
TA  - Arch Phys Med Rehabil
JT  - Archives of physical medicine and rehabilitation
JID - 2985158R
SB  - IM
MH  - Adult
MH  - Cohort Studies
MH  - Female
MH  - Humans
MH  - Male
MH  - Recovery of Function
MH  - Retrospective Studies
MH  - *Spinal Cord Injuries/rehabilitation
MH  - Trauma Severity Indices
MH  - United States
OTO - NOTNLM
OT  - Outcome measures
OT  - Rehabilitation
OT  - Spinal cord injury
OT  - Trauma
EDAT- 2021/12/23 06:00
MHDA- 2022/04/06 06:00
CRDT- 2021/12/22 20:09
PHST- 2021/09/28 00:00 [received]
PHST- 2021/12/05 00:00 [revised]
PHST- 2021/12/08 00:00 [accepted]
PHST- 2021/12/23 06:00 [pubmed]
PHST- 2022/04/06 06:00 [medline]
PHST- 2021/12/22 20:09 [entrez]
AID - S0003-9993(21)01727-5 [pii]
AID - 10.1016/j.apmr.2021.12.001 [doi]
PST - ppublish
SO  - Arch Phys Med Rehabil. 2022 Apr;103(4):642-648.e2. doi: 
      10.1016/j.apmr.2021.12.001. Epub 2021 Dec 20.