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在成年人中创伤性脊髓损伤的神经预测指南

Dea Mahanes¹, Susanne Muehlschlegel², Katja E Wartenberg³

¹Departments of Neurology and Neurosurgery, UVA Health, University of Virginia, Charlottesville, VA, USA.

Neurocritical care

|November 13, 2023

概括

临床医生可以使用MRI发现,损伤程度和严重程度来预测创伤性脊髓损伤 (tSCI) 后的结果. 荷兰的临床预测规则有助于预测伤害后一年的行走恢复.

科学领域:

神经科学是一个神经科学.
临床医学临床医学
康复医学康复医学康复医学

背景情况:

创伤性脊髓损伤 (tSCI) 为患者和家人带来了重大长期挑战.
准确的预后信息对于明智的决策和未来规划至关重要.
需要指导方针来评估SCI中神经预测早期临床预测者的可靠性.

研究的目的:

评估急性期临床预测器在成人创伤性脊髓损伤中神经预测的可靠性.
指导临床医生为患者及其代孕妇提供有关死亡率和功能结果的咨询.
建立基于证据的建议,以预测Sts.CI后的恢复.

主要方法:

使用推评估,开发和评估 (GRADE) 方法进行了叙事系统审查.
候选预测因素和模型是根据临床相关性和证据质量进行选择的.
根据证据质量,后果平衡,价值观,偏好和资源使用,制定了建议.

主要成果:

病理性MRI发现,神经水平和损伤严重程度是美国脊髓损伤损伤量表 (ASIA) 改善的中等可靠预测指标.
荷兰临床预测规则是一个适度可靠的模型,用于预测tSCI后一年的独立行走.
在急性阶段没有发现其他可靠的死亡率或功能结果预测指标.

结论:

这些指南提供了关于急性预测死亡率,功能结果,ASIA等级转换和行走恢复的可靠性方面的建议.
临床医生应该考虑完整的临床图像,而不是单独的变量用于神经预测.
关于潜在的缺陷和恢复的有效沟通对于患者和代孕母亲的咨询至关重要.

关键词:

功能状态功能状态结果结果的结果.预测预后预测预测脊髓损伤造成的伤害创伤是一个创伤.

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