Concomitant TBI did not significantly affect survival after acute spinal cord injury
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Among patients with traumatic brain and spinal cord injuries, cervical spinal cord injury was more severe and led to worse neurological and functional outcomes compared with those with only spinal cord injury, but survival was not affected.
Julio C. Furlan, MD, LLB, MBA, MSc, PhD, FRCPC, a staff neurologist and a clinician investigator at the Toronto Rehabilitation Institute in Canada, presented these findings at the American Neurological Association Annual Meeting.
“At least one-third of individuals with spinal cord injury [SCI] have some degree of traumatic brain injury, and the effects of traumatic brain injury on their recovery remains understudied,” Furlan said during a virtual presentation.
In their retrospective cohort study, Furlan and colleagues investigated possible effects of concomitant TBI on survival, as well as on neurological and functional recovery, within 1 year of acute traumatic SCI. They included 499 participants of the Third National Spinal Cord Injury Study (NASCIS 3), with TBI defined as Glasgow Coma Score below 15 at admission in an acute care facility.
Researchers compared those with a dual diagnosis of SCI plus TBI with those who had SCI only. They analyzed survival via Kaplan-Meier curve and log-rank test. Further, they assessed neurological recovery via the NASCIS motor, sensory and pain scores using multivariate and multiple regression analyses, as well as functional outcome via Functional Independence Measure (FIM) score using multivariate and multiple regression analyses.
Results showed a significantly higher proportion of the TBI plus SCI group had more severe and cervical SCIs, higher blood alcohol concentrations at admission and more frequently received 48-hour methylprednisolone sodium succinate after SCI compared with the SCI-alone group. Both study groups were comparable regarding age at the time of trauma, sex distribution and cause of trauma, according to the study abstract.
“Concomitant TBI did not significantly affect survival rates within the first year after acute traumatic SCI,” Furlan said during the presentation.