In:
Global Spine Journal, SAGE Publications
Abstract:
Retrospective Cohort Study. Objectives To determine the ability of early vital sign abnormalities to predict functional independence in patients with SCI that required surgery. Methods A retrospective analysis of data extracted from the Pennsylvania Trauma Outcome Study database. Inclusion criteria were patients 〉 18 years with a diagnosis of SCI who required urgent spine surgery in Pennsylvania from 1/1/2010-12/31/2020 and had complete records available. Results A total of 644 patients met the inclusion criteria. The mean age was 47.1 ± 14.9 years old and the mean injury severity score (ISS) was 22.3 ± 12.7 with the SCI occurring in the cervical, thoracic, and lumbar spine in 61.8%, 19.6% and 18.0%, respectively. Multivariable logistic regression analyses for predictors of functional independence at discharge showed that higher HR at the scene (OR 1.016, 95% CI 1.006-1.027, P = .002) and lower ISS score (OR .894, 95% CI .870-.920, P 〈 .001) were significant predictors of functional independence. Similarly, higher admission HR (OR 1.015, 95% CI 1.004-1.027, P = .008) and lower ISS score (OR .880, 95% CI 0.864-.914, P 〈 .001) were significant predictors of functional independence. Peak Youden indices showed that patients with HR at scene 〉 70 and admission HR ≥83 were more likely to achieve functional independence. Conclusions Early heart rate is a strong predictor of functional independence in patients with SCI. HR at scene 〉 70 and admission HR ≥83 is associated with improved outcomes, suggesting lack of neurogenic shock.
Type of Medium:
Online Resource
ISSN:
2192-5682
,
2192-5690
DOI:
10.1177/21925682231155127
Language:
English
Publisher:
SAGE Publications
Publication Date:
2023
detail.hit.zdb_id:
2648287-3
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