Spinal cord最新文献

{"title":"The feasibility and utility of intraoperative ultrasound in spinal cord injury patients: an international survey of AO spine members.","authors":"Chris J Neal, Olesja Hazenbiller, Christoph P Hofstetter, Bizhan Aarabi, James S Harrop, Michael G Fehlings, Shekar Kurpad, Vafa Rahimi-Movaghar, Brian K Kwon, James D Guest","doi":"10.1038/s41393-025-01072-2","DOIUrl":"10.1038/s41393-025-01072-2","url":null,"abstract":"<p><strong>Study design: </strong>Survey.</p><p><strong>Objectives: </strong>Intraoperative ultrasound (IOUS) is an emerging tool for assessing the injured spinal cord during surgical intervention and particularly after traumatic spinal cord injury (SCI). The extent of utilization of this technique is unknown. To assess whether a knowledge gap exists regarding IOUS in managing SCI patients, an international survey of spine surgeons was performed.</p><p><strong>Setting: </strong>International Survey.</p><p><strong>Methods: </strong>Members of the AO Spine international community were surveyed using a web-based questionnaire developed by an SCI expert commission. The categorical data were analyzed descriptively.</p><p><strong>Results: </strong>Of the 276 completed surveys, 22% (n = 61/276) indicated IOUS was utilized during spine surgery, with most responses coming from Europe (38% n = 24/61) and North America (30% n = 18/61). Only 41% (n = 25/61) had received formal IOUS training. There were 59% (n = 36/61) of respondents who indicated they use IOUS on patients with acute SCI, mainly to assess adequate decompression. Of those not using IOUS, 50% (n = 107/215) did not have access to an ultrasound machine available. Overall, 92% (n = 254/276) indicated that an IOUS training course would be beneficial to improve understanding and patient care.</p><p><strong>Conclusions: </strong>This international survey of spine surgeons demonstrated that currently, there is limited use of IOUS in the surgical management of acute SCI. Understanding the needs of spine surgeons and tailoring educational opportunities may increase the role of IOUS. Given the importance of surgical decompression in enhancing outcomes after acute SCI coupled with the ability of IOUS to assess decompression, greater adoption of IOUS could further enhance the efficacy of decompressive surgery.</p>","PeriodicalId":21976,"journal":{"name":"Spinal cord","volume":" ","pages":"252-256"},"PeriodicalIF":2.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143711364","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgical outcomes of cervical spinal cord tumor in elderly patients assessed by the Japanese Orthopedic Association Cervical Myelopathy Evaluation Questionnaire.","authors":"Shuhei Ito, Narihito Nagoshi, Toshiki Okubo, Masahiro Ozaki, Satoshi Suzuki, Kazuki Takeda, Takahito Iga, Morio Matsumoto, Masaya Nakamura, Kota Watanabe","doi":"10.1038/s41393-025-01075-z","DOIUrl":"10.1038/s41393-025-01075-z","url":null,"abstract":"<p><strong>Study design: </strong>Single-institution retrospective study.</p><p><strong>Objectives: </strong>To assess postoperative functional and quality of life (QOL) outcomes in elderly patients who underwent cervical spinal cord tumor surgery using the Japanese Orthopedic Association Cervical Myelopathy Evaluation Questionnaire (JOACMEQ).</p><p><strong>Setting: </strong>Single university hospital.</p><p><strong>Methods: </strong>This retrospective study included 97 patients who underwent surgery for cervical spinal cord tumors between 2000 and 2016. Patients were divided into two groups: a younger group (patients < 65 years old) and an elderly group (patients ≥ 65 years old). Surgical outcomes were evaluated using JOA scores and JOACMEQ, with statistical comparisons between age (younger vs. elderly) and tumor types (intramedullary vs. extramedullary).</p><p><strong>Results: </strong>Preoperative JOA scores were significantly lower in the elderly group compared to the younger group. Postoperative recovery rates were similar between the two groups. Extramedullary tumor resections in the elderly showed notable functional improvements. Conversely, elderly patients with intramedullary tumors exhibited poorer outcomes in lower extremity function and QOL, as measured by the JOACMEQ.</p><p><strong>Conclusion: </strong>Surgical intervention for cervical spinal cord tumors in elderly patients can yield functional and QOL outcomes similar to those in younger patients, especially for extramedullary tumors. However, intramedullary tumor resections in the elderly may result in less favorable outcomes, particularly in lower limb function and QOL. These findings underscore the importance of thorough preoperative counseling for elderly patients, highlighting potential risks and benefits based on tumor type.</p>","PeriodicalId":21976,"journal":{"name":"Spinal cord","volume":" ","pages":"239-245"},"PeriodicalIF":2.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143693357","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quantifying guideline-discordant intermittent catheterization in adults hospitalized with spinal cord injury: a retrospective cohort study.","authors":"Mengdong He, Emily Hon, Lin Xu, Stephen Hampton, Kimberly Waddell","doi":"10.1038/s41393-025-01078-w","DOIUrl":"10.1038/s41393-025-01078-w","url":null,"abstract":"<p><strong>Study design: </strong>Retrospective cohort study.</p><p><strong>Objectives: </strong>To characterize guideline-discordant clean intermittent catheterization (CIC) during hospitalizations of patients with spinal cord injury (SCI), explore predictors of guideline-discordant CIC, and examine its association with urinary tract infection (UTI).</p><p><strong>Setting: </strong>Acute care hospitals within a large academic health system.</p><p><strong>Methods: </strong>Using electronic health records (9/1/2021-9/30/2023), we identified adults hospitalized with a discharge diagnosis of SCI and ≥1 documented CIC bladder output. The primary outcome was guideline-discordant CIC (bladder output volume >500 mL and/or time between CIC > 6 h). Generalized linear model and Chi-square test were used to evaluate patient factors and UTI risk associated with guideline-discordant CIC.</p><p><strong>Results: </strong>The study included 413 patients with SCI covering 8,016 CIC measurements during 519 hospitalizations. Their mean (SD) age was 55.2 (20.6) years, with 34.7% female and 46.8% Black. 52.8% were covered by Medicare. 79.4% had a thoracolumbar-level SCI. 50.2% of CICs were guideline-discordant. Males and those with managed care insurance had significantly higher odds of guideline-discordant CIC (OR = 1.34, 95% CI, 1.03 to 1.73 and OR = 2.05, 95% CI, 1.18 to 3.54, respectively). Patients with an indwelling catheter for ≥12 days before initiating CIC had significantly lower odds of guideline-discordant CIC (OR = 0.65, 95% CI, 0.49 to 0.84). The UTI incidence was 12.5% in hospitalizations with guideline-discordant CIC compared to 10.4% with guideline-concordant CIC (P = 0.49).</p><p><strong>Conclusions: </strong>Half of CICs did not adhere to guidelines, highlighting the need for quality improvement initiatives. Further research examining the association between UTI and CIC care patterns is warranted.</p>","PeriodicalId":21976,"journal":{"name":"Spinal cord","volume":"63 5","pages":"270-276"},"PeriodicalIF":2.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12074987/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144044613","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors impacting employment outcomes for persons with spinal cord injury in South Korea.","authors":"Kwang-Jin Jung, Yong-Tak Kim, Mi-Ri Jeon, Chan-Woo Lee, Keum-Jin Lee","doi":"10.1038/s41393-025-01076-y","DOIUrl":"10.1038/s41393-025-01076-y","url":null,"abstract":"<p><strong>Study design: </strong>Cross-sectional survey.</p><p><strong>Objectives: </strong>To identify the factors determining the employment of individuals with spinal cord injury (SCI) living in South Korea, which shows a lower-than-average employment rate in international comparative studies, and to examine the potential importance for policy.</p><p><strong>Setting: </strong>Community of patients with SCI who are members of the Korea Spinal Cord Injury Association (KSCIA).</p><p><strong>Methods: </strong>A survey involving 200 members of the KSCIA was conducted. In the analysis, we included 177 individuals aged 15-64 years and were at least 2 years post-injury at the time of the survey. Descriptive statistics were calculated and logistic regression was applied to examine the association between 11 variables and employment outcomes.</p><p><strong>Results: </strong>A higher \"education level\" and participation in \"vocational rehabilitation services\" were positively associated with employment for individuals with SCI. By contrast, \"receiving welfare benefits\" was negatively associated with employment probability. The analysis, which categorized employment predictors into human capital, injury, and environmental models, showed no associations for factors in the Injury Model but indicated positive associations for education in the Human Capital Model and for receiving compensation in the form of welfare benefits and participation in vocational rehabilitation services in the Environment Model.</p><p><strong>Conclusions: </strong>Among the three models, the Environment Model had the greatest explanatory power. This suggests that in Korea, policy interventions targeting modifiable environmental factors hold significant potential to improve employment outcomes for individuals with SCI.</p>","PeriodicalId":21976,"journal":{"name":"Spinal cord","volume":" ","pages":"257-262"},"PeriodicalIF":2.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143721545","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Urodynamic evaluation of neurogenic bladder in patients with spinal cord injury within 6 months post-injury: a Retrospective Cross-Sectional Study.","authors":"Onyoo Kim, Lyekyung An, Byung Chan Lee","doi":"10.1038/s41393-025-01074-0","DOIUrl":"10.1038/s41393-025-01074-0","url":null,"abstract":"<p><strong>Study design: </strong>Retrospective cross-sectional survey of Korean patients with spinal cord injury (SCI) within 6 months post-injury.</p><p><strong>Objectives: </strong>To evaluate urodynamic parameters and identify unfavorable urodynamic findings in patients with neurogenic bladder due to SCI during the acute to subacute stages of the disease based on the post-injury time interval.</p><p><strong>Setting: </strong>National Rehabilitation Center, Seoul, Korea.</p><p><strong>Methods: </strong>Data from urodynamic tests performed on individuals with SCI within 6 months post-injury were collected. Based on the time interval from injury to testing, the recruited patients were divided into three groups: 0-90 days, 91-135 days, and 136-180 days. Based on these groups, urodynamic test parameters and incidence of high-risk findings (high detrusor pressure exceeding 40 cmH₂O during the filling phase, low compliance of the bladder, and detrusor-sphincter dyssynergia [DSD]) and unfavorable urodynamic findings (detrusor overactivity [DO], underactive or acontractile bladder) were compared.</p><p><strong>Results: </strong>Analysis of urodynamic study (UDS) findings in 191 individuals with acute to subacute SCI, revealed that unfavorable urodynamic findings were observed within 3 months after injury in both complete and incomplete SCI. The UDS test results and incidence of unfavorable outcomes based on the interval between injury and examination showed no significant statistical differences over time.</p><p><strong>Conclusions: </strong>The urodynamics of individuals with SCI suggest that high-risk or unfavorable urodynamic results are common in the acute to subacute stages of SCI.</p>","PeriodicalId":21976,"journal":{"name":"Spinal cord","volume":" ","pages":"246-251"},"PeriodicalIF":2.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12074986/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143701682","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring the mediating effects of coping strategies on adjustment after sustaining a spinal cord injury.","authors":"Dinalize Purcell, Vegard Strøm, Annelie S Leiulfsrud","doi":"10.1038/s41393-025-01062-4","DOIUrl":"10.1038/s41393-025-01062-4","url":null,"abstract":"<p><strong>Study design: </strong>Cross-sectional study of adults living with a spinal cord injury (SCI) in Norway.</p><p><strong>Objectives: </strong>Using the Norwegian data from the International Spinal Cord Injury Community Survey (InSCI), we firstly aimed to examine the mediating effect of self-efficacy and active coping strategies on the relationship between functional independence and level of adjustment as proposed by the Spinal Cord Injury Adjustment Model (SCIAM). Secondly, to examine potential gender differences in levels of adjustment after sustaining an SCI. This study used a comprehensive adjustment variable.</p><p><strong>Setting: </strong>SCI population in Norway.</p><p><strong>Methods: </strong>The first objective was tested with a measure of mediation analysis and the second objective with an independent two sample t-test.</p><p><strong>Results: </strong>A total of 610 participants responded to the questionnaire, with a mean age of 57 years, and 68,5% being male. Psychological resources fully mediated the effect of functional independence on adjustment. There was a statistically significant double mediation effect, first through self-efficacy and, then through active coping strategies (β = 0,02; 95% CI 0.01-0.03). The pathway from functional independence through active coping strategies to adjustment showed the strongest mediation proportion of 0.49. The difference in adjustment levels between males and females was 2.90 out of 100 (95% CI: 0.19-5.61).</p><p><strong>Conclusions: </strong>Self-efficacy and active coping strategies were found as mediating factors in the relationship between functional independence and adjustment. These factors are important to consider during SCI rehabilitation. Females had a slightly lower level of adjustment than males.</p>","PeriodicalId":21976,"journal":{"name":"Spinal cord","volume":" ","pages":"208-213"},"PeriodicalIF":2.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143391927","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Sir Ludwig Guttmann lecture 2023: psychosocial factors and adjustment dynamics after spinal cord injury.","authors":"Ashley Craig","doi":"10.1038/s41393-025-01060-6","DOIUrl":"10.1038/s41393-025-01060-6","url":null,"abstract":"<p><strong>Study design: </strong>Narrative review OBJECTIVES: Sir Ludwig Guttmann realised spinal cord injury (SCI) rehabilitation should incorporate more than a biomedical approach if SCI patients were to adjust to their injury and achieve productive social re-integration. He introduced components into rehabilitation he believed would assist his patients build physical strength as well as psychological resilience that would help them re-engage with their communities. We pay tribute to Sir Ludwig by presenting research that has focussed on psychosocial factors that contribute to adjustment dynamics after SCI.</p><p><strong>Setting: </strong>Not applicable.</p><p><strong>Methods: </strong>Five factors with a psychosocial source will be examined, featured in my research, namely psychological distress, cognitive impairment, pain catastrophizing, sleep disorder and fatigue. A multifactorial model of adjustment will be examined.</p><p><strong>Results: </strong>Evidence shows these factors can be significant barriers to adjustment and reciprocally related to self-efficacy and life decisions. A theoretical rehabilitation framework/model is presented called the SCI Adjustment Model (SCIAM), that explains the process of adjustment dynamics. It describes how multifactorial factors contribute to adjustment in a non-linear process over time.</p><p><strong>Conclusions: </strong>Key clinical messages include: (i) adjustment dynamics will be enhanced if viewed through the lens of a multifactorial model that clarifies how multiple psychosocial factors can combine and act as barriers or facilitators to adjustment; (ii) judiciously using this information, assess and then strategize to reduce the influence of barriers or strengthen facilitators during SCI rehabilitation and beyond, and (iii) integrate psychosocial guidelines and a person-centred approach into SCI rehabilitation to achieve treatment goals.</p>","PeriodicalId":21976,"journal":{"name":"Spinal cord","volume":" ","pages":"194-200"},"PeriodicalIF":2.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12003166/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143011940","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Validity and reliability of the Turkish version of the Spinal Cord Independence Measure (SCIM III) self-report.","authors":"Yelda Soluk Özdemir, Cansın Medin Ceylan, Nurdan Paker, Veysel Korkut, Burak Kütük, Kadriye Öneş, Derya Buğdaycı, Fatma N Kesiktaş","doi":"10.1038/s41393-025-01069-x","DOIUrl":"10.1038/s41393-025-01069-x","url":null,"abstract":"<p><strong>Study design: </strong>A cross-sectional validation study.</p><p><strong>Objectives: </strong>The aim of the study was to create a Turkish version of the Spinal Cord Independence Measure Self-Report (SCIM-SR) scale and verify its validity and reliability.</p><p><strong>Setting: </strong>Rehabilitation Department at Istanbul Physical Medicine and Rehabilitation and Training Research Hospital.</p><p><strong>Methods: </strong>The Turkish version of SCIM-SR was translated from English using forward and backward translation in accordance with standard guidelines and 90 participants completed the SCIM-SR Turkish form. At the same time, a Spinal Cord Independence Measure III (SCIM III) was administered to the participants by a health professional through observation. Cronbach's alpha, Pearson and Spearman correlation coefficients were used to evaluate the internal consistency and concurrent validity.</p><p><strong>Results: </strong>The Cronbach's α coefficients for the total scale was 0.883. For the subscales, it was 0.929 for self-care, 0.571 for respiration and sphincter management and 0.885 for mobility. Test-retest reliability after two weeks yielded Spearman coefficients above 0.92 for the total scale and all subscales. When analyzing the correlation between SCIM-SR and SCIM III, the intraclass correlation average and its lower and upper bound values were as follows: 0.984 (0.976-0.990) for self-care; 0.970 (0.955-0.980) for respiration and sphincter management; 0.968 (0.951-0.979) for mobility and 0.980 (0.969-0.987) for the total. There was good agreement between SCIM-SR and SCIM III when evaluating the total score in Bland-Altman graphs. The Bland-Altman analysis revealed no significant proportional bias (0.76; 95% CI [-21.34, 22.87]), but a significant fixed bias was observed.</p><p><strong>Conclusions: </strong>The Turkish version of SCIM-SR demonstrated excellent internal consistency and good validity in Turkish individuals with spinal cord injury.</p>","PeriodicalId":21976,"journal":{"name":"Spinal cord","volume":" ","pages":"222-226"},"PeriodicalIF":2.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143504289","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The critical threshold of blood flow associated with spinal cord ischemia in a modified rabbit model developed by ligation of lumbar arteries.","authors":"Li-Feng Xing, Ding-Wen Zheng, Yan-Song Miao, Yu-Cai Hong, Wei Xiao","doi":"10.1038/s41393-025-01071-3","DOIUrl":"10.1038/s41393-025-01071-3","url":null,"abstract":"<p><strong>Study design: </strong>Animal study.</p><p><strong>Objectives: </strong>To investigate the influence of lumbar arteries ligation on spinal cord blood flow (SCBF), and to determine by what proportion the SCBF decrease would cause spinal cord ischemia (SCI) in rabbit model.</p><p><strong>Setting: </strong>Sir Run Run Shaw Hospital, Zhejiang University School of Medicine.</p><p><strong>Methods: </strong>SCI model was established by ligation of lumbar arteries in rabbits. 20 rabbits were divided into four groups: group A, sham surgery without ligation; group B, ligation at 3 levels; group C, ligation at 4 levels; group D, ligation at 5 levels. The SCBF was measured with laser doppler flowmetry, motor function was assessed using modified Tarlov grading system, and neurophysiological integrity was detected with motor-evoked potential (MEP), followed by histological observation on the seventh day after operation.</p><p><strong>Results: </strong>Lumbar arteries ligation at 3 levels led to average 40% decrease of SCBF, and spinal cord remained functional, electrophysiological and histological normal. Lumbar arteries ligation at 4 levels resulted in average 50% decrease of SCBF, slight motor dysfunction, prolonged latency of MEP and decreased cell volume of neuron, rabbits presented mild spinal cord injury. Lumbar arteries ligation at 5 levels caused average 60% decrease of SCBF, complete paraplegia, loss of MEP waveform and neuron karyopyknosis, rabbits presented severe SCI.</p><p><strong>Conclusion: </strong>More ligation of bilateral lumbar arteries leads to lower SCBF and increase the risk of SCI in rabbits, SCBF decreased by more than 50% could cause SCI. MEP associated significantly with SCBF, suggesting the usefulness of MEP to monitoring SCBF in surgery.</p>","PeriodicalId":21976,"journal":{"name":"Spinal cord","volume":" ","pages":"233-238"},"PeriodicalIF":2.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12003188/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143658715","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Utilization of machine learning algorithm in the prediction of rehospitalization during one-year post traumatic spinal cord injury.","authors":"Salma Aly, Yuying Chen, Abdulaziz Ahmed, Huacong Wen, Tapan Mehta","doi":"10.1038/s41393-024-01055-9","DOIUrl":"10.1038/s41393-024-01055-9","url":null,"abstract":"<p><strong>Study design: </strong>Retrospective cohort study.</p><p><strong>Objective: </strong>The primary aim was to develop a machine learning (ML) model to predict rehospitalization during the first year of traumatic spinal cord injury (TSCI) and to identify top predictors using data obtained during initial rehabilitation. The secondary aim was to predict prolonged hospital stay among the rehospitalized group.</p><p><strong>Setting: </strong>Eighteen SCI Model Systems centers throughout the United States.</p><p><strong>Methods: </strong>Data were retrieved from the National Spinal Cord Injury Model Systems Database. The participants were divided into 2 groups based on rehospitalization during the first year of injury. Those who experienced rehospitalization during first year were further grouped into prolonged stay (>75th quartile of the total length of stay) or non-prolonged stay. Variables considered in models included socio-demographic factors, clinical characteristics, and comorbidities.</p><p><strong>Results: </strong>The best performing classification models were Random Forest for predicting rehospitalization and Adaptive Boosting for prolonged stay. The most important predictors in both models were the degree of functional independence, American Spinal Injury Association (ASIA) scores, age, days from injury to rehabilitation admission and body mass index. Additionally, for prolonged stays, pressure injury as a reason for rehospitalization was top predictor.</p><p><strong>Conclusion: </strong>Functional Independence Measure (FIM) and ASIA scores emerge as key predictors of both rehospitalizations and prolonged rehospitalizations. These findings may assist clinicians in patient risk assessment. Furthermore, the identification of pressure injury as a primary predictor for prolonged stays signifies a targeted focus on preventive measures for pressure injury-related rehospitalizations, offering a specific strategy to enhance patient care and outcomes.</p>","PeriodicalId":21976,"journal":{"name":"Spinal cord","volume":" ","pages":"214-221"},"PeriodicalIF":2.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12003193/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143426345","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}