دورية أكاديمية
Methylprednisolone Therapy in Acute Traumatic Spinal Cord Injury: Analysis of a Regional Spinal Cord Model Systems Database.
| العنوان: | Methylprednisolone Therapy in Acute Traumatic Spinal Cord Injury: Analysis of a Regional Spinal Cord Model Systems Database. |
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| المؤلفون: | Sunshine JE; From the *Department of Anesthesiology and Pain Medicine, University of Washington, Seattle; †Orthopaedics and Sports Medicine, Harborview Medical Center, University of Washington, Seattle, Washington; ‡Spinal Cord Injury Service, Veterans Affairs Puget Sound Health Care System, Seattle, Washington; Departments of §Rehabilitation and ‖Neurosurgery, Harborview Medical Center, University of Washington, Seattle, Washington., Dagal A, Burns SP, Bransford RJ, Zhang F, Newman SF, Nair BG, Sharar SR |
| المصدر: | Anesthesia and analgesia [Anesth Analg] 2017 Apr; Vol. 124 (4), pp. 1200-1205. |
| نوع المنشور: | Journal Article; Multicenter Study; Observational Study; Research Support, U.S. Gov't, Non-P.H.S. |
| اللغة: | English |
| بيانات الدورية: | Publisher: Lippincott Williams & Wilkins Country of Publication: United States NLM ID: 1310650 Publication Model: Print Cited Medium: Internet ISSN: 1526-7598 (Electronic) Linking ISSN: 00032999 NLM ISO Abbreviation: Anesth Analg Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: 1998- : Baltimore, Md. : Lippincott Williams & Wilkins Original Publication: Cleveland, International Anesthesia Research Society. |
| مواضيع طبية MeSH: | Databases, Factual*, Anti-Inflammatory Agents/*therapeutic use , Methylprednisolone/*therapeutic use , Recovery of Function/*physiology , Spinal Cord Injuries/*diagnosis , Spinal Cord Injuries/*drug therapy, Adult ; Anti-Inflammatory Agents/pharmacology ; Cohort Studies ; Female ; Humans ; Linear Models ; Male ; Methylprednisolone/pharmacology ; Middle Aged ; Recovery of Function/drug effects ; Retrospective Studies ; Spinal Cord Injuries/physiopathology |
| مستخلص: | Background: The objective of this study was to assess the relationship between exposure to methylprednisolone (MP) and improvements in motor function among patients with acute traumatic spinal cord injury (TSCI). MP therapy for patients with TSCI is controversial because of the current conflicting evidence documenting its benefits and risks. Methods: We conducted a retrospective cohort study from September 2007 to November 2014 of 311 patients with acute TSCI who were enrolled into a model systems database of a regional, level I trauma center. We linked outcomes and covariate data from the model systems database with MP exposure data from the electronic medical record. The primary outcomes were rehabilitation discharge in American Spinal Injury Association (ASIA) motor scores (sum of 10 key muscles bilaterally as per International Standards for Neurological Classification of Spinal Cord Injury, range, 0-100) and Functional Independence Measure (FIM) motor scores (range, 13-91). Secondary outcomes measured infection risk and gastrointestinal (GI) complications among MP recipients. For the primary outcomes, multivariable linear regression was used. Results: There were 160 MP recipients and 151 nonrecipients. Adjusting for age, sex, weight, race, respective baseline motor score, surgical intervention, injury level, ASIA Impairment Scale (AIS) grade, education, and insurance status, there was no association with improvement in discharge ASIA motor function or FIM motor score among MP recipients: -0.34 (95% CI, -2.8, 2.1) and 0.75 (95% CI, -2.8, 4.3), respectively. Adjusting for age, sex, race, weight, injury level, and receipt of surgery, no association with increased risk of infection or GI complications was observed. Conclusions: This retrospective cohort study involving patients with acute TSCI observed no short-term improvements in motor function among MP recipients compared with nonrecipients. Our findings support current recommendations that MP use in this population should be limited. |
| المشرفين على المادة: | 0 (Anti-Inflammatory Agents) X4W7ZR7023 (Methylprednisolone) |
| تواريخ الأحداث: | Date Created: 20170321 Date Completed: 20170713 Latest Revision: 20180105 |
| رمز التحديث: | 20240829 |
| DOI: | 10.1213/ANE.0000000000001906 |
| PMID: | 28319547 |
| قاعدة البيانات: | MEDLINE |
Full Text Finder | تدمد: | 1526-7598 |
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| DOI: | 10.1213/ANE.0000000000001906 |