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Establishment and verification of a surgical prognostic model for cervical spinal cord injury without radiological abnormality

摘要Some studies have suggested that early surgical treatment can effectively improve the prognosis of cervical spinal cord injury without radiological abnormality, but no research has focused on the development of a prognostic model of cervical spinal cord injury without radiological abnormality. This retrospective analysis included 43 patients with cervical spinal cord injury without radiological abnormal-ity. Seven potential factors were assessed: age, sex, external force strength causing damage, duration of disease, degree of cervical spinal stenosis, Japanese Orthopaedic Association score, and physiological cervical curvature. A model was established using multiple binary lo-gistic regression analysis. The model was evaluated by concordant profiling and the area under the receiver operating characteristic curve. Bootstrapping was used for internal validation. The prognostic model was as follows: logit(P) = ?25.4545 + 21.2576VALUE + 1.2160SCORE? 3.4224TIME, where VALUE refers to the Pavlov ratio indicating the extent of cervical spinal stenosis, SCORE refers to the Japanese Or-thopaedic Association score (0–17) after the operation, and TIME refers to the disease duration (from injury to operation). The area under the receiver operating characteristic curve for all patients was 0.8941 (95% confidence interval, 0.7930–0.9952). Three factors assessed in the predictive model were associated with patient outcomes: a great extent of cervical stenosis, a poor preoperative neurological status, and a long disease duration. These three factors could worsen patient outcomes. Moreover, the disease prognosis was considered good when logit(P) ≥ ?2.5105. Overall, the model displayed a certain clinical value. This study was approved by the Biomedical Ethics Committee of the Second Affiliated Hospital of Xi'an Jiaotong University, China (approval number: 2018063) on May 8, 2018.

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作者单位 Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi Province, China [1] Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi Province, China;Health Science Center, Xi'an Jiaotong University, Xi'an, Shaanxi Province, China [2]
DOI 10.4103/1673-5374.247480
发布时间 2019-01-25(万方平台首次上网日期,不代表论文的发表时间)
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中国神经再生研究(英文版)

中国神经再生研究(英文版)

2019年14卷4期

713-720页

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