Replication and novel analysis of age and sex effects on the neurologic and functional value of each spinal segment in the US healthcare setting.


Journal

Spinal cord
ISSN: 1476-5624
Titre abrégé: Spinal Cord
Pays: England
ID NLM: 9609749

Informations de publication

Date de publication:
Feb 2019
Historique:
received: 31 05 2018
accepted: 10 09 2018
revised: 17 08 2018
pubmed: 7 10 2018
medline: 4 4 2019
entrez: 7 10 2018
Statut: ppublish

Résumé

Replication of previously developed prognostic model. In motor complete injuries at admission to rehabilitation, perform; (1) replication analyses of the relationships between ISNCSCI motor level and motor scores and SCIM and (2) novel analyses to determine if age and/or sex moderate relationship between neurological impairment and function. Admission to initial inpatient rehabilitation in the United States. Post-Hoc analyses of data collected as part of a separate study. Replication analyses: (1) Pearson's correlation assessed relationship strength between neurologic impairment and function. (2) Multiple linear regression assessed if center or age influenced functional outcome. Novel analyses: (1) Moderated multiple regression assessed if age and/or sex moderated the lesion level-function relationship. Of the 406 datasets, 161 were motor complete injuries, and included in the analyses. Median time post injury at admission to rehabilitation was 19 days. Our replication analyses confirmed the neurologic and functional value of each spinal segment reported by the EM-SCI group (all p ≤ 0.018). We failed to confirm their reported age effect (p = 0.05) and non-effect of center (p = 0.037). Our novel analyses indicated that age coded as above/below 50 moderated the relationship between neurologic impairment and function (p = 0.038) in cervical injuries only, but that age coded as above/below 35 (all p ≥ 0.510) and sex (all p ≥ 0.465) did not. The neurological and functional value of each segment is consistent across very different healthcare settings in early and late sub-acute stages and minimally impacted by age and sex. Differences related to centers and age may confound efficacy trials. The Miami Project to Cure Paralysis; The Craig H. Neilsen Foundation (83492).

Identifiants

pubmed: 30291312
doi: 10.1038/s41393-018-0206-8
pii: 10.1038/s41393-018-0206-8
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

156-164

Subventions

Organisme : Craig H. Neilsen Foundation
ID : 83492
Organisme : Craig H. Neilsen Foundation
ID : 83492

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Auteurs

Rachel E Cowan (RE)

Department of Neurosurgery and Miami Project to Cure Paralysis, Miller School of Medicine, University of Miami, Miami, Fl, USA.

Kim D Anderson (KD)

Department of Physical Medicine and Rehabilitation, MetroHealth Medical Center, Institute for Functional Restoration, Case Western Reserve University, Cleveland, OH, USA. kxa304@case.edu.

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