Acute Adverse Events After Spinal Cord Injury and Their Relationship to Long-term Neurologic and Functional Outcomes: Analysis From the North American Clinical Trials Network for Spinal Cord Injury

Research output: Contribution to journalArticle

North American Clinical Trials Network Collaborators, Fan Jiang, Blessing N.R. Jaja, Shekar N. Kurpad, Jetan H. Badhiwala, Bizhan Aarabi, Robert G. Grossman, James S. Harrop, Jim D. Guest, Ralph T. Schär, Chris I. Shaffrey, Max Boakye, Elizabeth G. Toups, Jefferson R. Wilson, Michael G. Fehlings

OBJECTIVES: There are few contemporary, prospective multicenter series on the spectrum of acute adverse events and their relationship to long-term outcomes after traumatic spinal cord injury. The goal of this study is to assess the prevalence of adverse events after traumatic spinal cord injury and to evaluate the effects on long-term clinical outcome. DESIGN: Multicenter prospective registry. SETTING: Consortium of 11 university-affiliated medical centers in the North American Clinical Trials Network. PATIENTS: Eight-hundred one spinal cord injury patients enrolled by participating centers. INTERVENTIONS: Appropriate spinal cord injury treatment at individual centers. MEASUREMENTS AND MAIN RESULTS: A total of 2,303 adverse events were recorded for 502 patients (63%). Penalized maximum logistic regression models were fitted to estimate the likelihood of neurologic recovery (ASIA Impairment Scale improvement ≥ 1 grade point) and functional outcomes in subjects who developed adverse events at 6 months postinjury. After accounting for potential confounders, the group that developed adverse events showed less neurologic recovery (odds ratio, 0.55; 95% CI, 0.32-0.96) and was more likely to require assisted breathing (odds ratio, 6.55; 95% CI, 1.17-36.67); dependent ambulation (odds ratio, 7.38; 95% CI, 4.35-13.06) and have impaired bladder (odds ratio, 9.63; 95% CI, 5.19-17.87) or bowel function (odds ratio, 7.86; 95% CI, 4.31-14.32) measured using the Spinal Cord Independence Measure subscores. CONCLUSIONS: Results from this contemporary series demonstrate that acute adverse events are common and are associated with worsened long-term outcomes after traumatic spinal cord injury.

Original languageEnglish (US)
Pages (from-to)e854-e862
JournalCritical Care Medicine
Volume47
Issue number11
DOIs
StatePublished - Nov 1 2019

PMID: 31389834

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Acute Adverse Events After Spinal Cord Injury and Their Relationship to Long-term Neurologic and Functional Outcomes : Analysis From the North American Clinical Trials Network for Spinal Cord Injury. / North American Clinical Trials Network Collaborators.

In: Critical Care Medicine, Vol. 47, No. 11, 01.11.2019, p. e854-e862.

Research output: Contribution to journalArticle

Harvard

North American Clinical Trials Network Collaborators 2019, 'Acute Adverse Events After Spinal Cord Injury and Their Relationship to Long-term Neurologic and Functional Outcomes: Analysis From the North American Clinical Trials Network for Spinal Cord Injury' Critical Care Medicine, vol. 47, no. 11, pp. e854-e862. https://doi.org/10.1097/CCM.0000000000003937

APA

North American Clinical Trials Network Collaborators (2019). Acute Adverse Events After Spinal Cord Injury and Their Relationship to Long-term Neurologic and Functional Outcomes: Analysis From the North American Clinical Trials Network for Spinal Cord Injury. Critical Care Medicine, 47(11), e854-e862. https://doi.org/10.1097/CCM.0000000000003937

Vancouver

North American Clinical Trials Network Collaborators. Acute Adverse Events After Spinal Cord Injury and Their Relationship to Long-term Neurologic and Functional Outcomes: Analysis From the North American Clinical Trials Network for Spinal Cord Injury. Critical Care Medicine. 2019 Nov 1;47(11):e854-e862. https://doi.org/10.1097/CCM.0000000000003937

Author

North American Clinical Trials Network Collaborators. / Acute Adverse Events After Spinal Cord Injury and Their Relationship to Long-term Neurologic and Functional Outcomes : Analysis From the North American Clinical Trials Network for Spinal Cord Injury. In: Critical Care Medicine. 2019 ; Vol. 47, No. 11. pp. e854-e862.

BibTeX

@article{37494e8c0e2f4ab3b0ceb7db08a6bb87,
title = "Acute Adverse Events After Spinal Cord Injury and Their Relationship to Long-term Neurologic and Functional Outcomes: Analysis From the North American Clinical Trials Network for Spinal Cord Injury",
abstract = "OBJECTIVES: There are few contemporary, prospective multicenter series on the spectrum of acute adverse events and their relationship to long-term outcomes after traumatic spinal cord injury. The goal of this study is to assess the prevalence of adverse events after traumatic spinal cord injury and to evaluate the effects on long-term clinical outcome. DESIGN: Multicenter prospective registry. SETTING: Consortium of 11 university-affiliated medical centers in the North American Clinical Trials Network. PATIENTS: Eight-hundred one spinal cord injury patients enrolled by participating centers. INTERVENTIONS: Appropriate spinal cord injury treatment at individual centers. MEASUREMENTS AND MAIN RESULTS: A total of 2,303 adverse events were recorded for 502 patients (63{\%}). Penalized maximum logistic regression models were fitted to estimate the likelihood of neurologic recovery (ASIA Impairment Scale improvement ≥ 1 grade point) and functional outcomes in subjects who developed adverse events at 6 months postinjury. After accounting for potential confounders, the group that developed adverse events showed less neurologic recovery (odds ratio, 0.55; 95{\%} CI, 0.32-0.96) and was more likely to require assisted breathing (odds ratio, 6.55; 95{\%} CI, 1.17-36.67); dependent ambulation (odds ratio, 7.38; 95{\%} CI, 4.35-13.06) and have impaired bladder (odds ratio, 9.63; 95{\%} CI, 5.19-17.87) or bowel function (odds ratio, 7.86; 95{\%} CI, 4.31-14.32) measured using the Spinal Cord Independence Measure subscores. CONCLUSIONS: Results from this contemporary series demonstrate that acute adverse events are common and are associated with worsened long-term outcomes after traumatic spinal cord injury.",
author = "{North American Clinical Trials Network Collaborators} and Fan Jiang and Jaja, {Blessing N.R.} and Kurpad, {Shekar N.} and Badhiwala, {Jetan H.} and Bizhan Aarabi and Grossman, {Robert G.} and Harrop, {James S.} and Guest, {Jim D.} and Sch{\"a}r, {Ralph T.} and Shaffrey, {Chris I.} and Max Boakye and Toups, {Elizabeth G.} and Wilson, {Jefferson R.} and Fehlings, {Michael G.}",
year = "2019",
month = "11",
day = "1",
doi = "10.1097/CCM.0000000000003937",
language = "English (US)",
volume = "47",
pages = "e854--e862",
journal = "Critical care medicine",
issn = "0090-3493",
publisher = "Lippincott Williams and Wilkins",
number = "11",

}

RIS

TY - JOUR

T1 - Acute Adverse Events After Spinal Cord Injury and Their Relationship to Long-term Neurologic and Functional Outcomes

T2 - Critical care medicine

AU - North American Clinical Trials Network Collaborators

AU - Jiang, Fan

AU - Jaja, Blessing N.R.

AU - Kurpad, Shekar N.

AU - Badhiwala, Jetan H.

AU - Aarabi, Bizhan

AU - Grossman, Robert G.

AU - Harrop, James S.

AU - Guest, Jim D.

AU - Schär, Ralph T.

AU - Shaffrey, Chris I.

AU - Boakye, Max

AU - Toups, Elizabeth G.

AU - Wilson, Jefferson R.

AU - Fehlings, Michael G.

PY - 2019/11/1

Y1 - 2019/11/1

N2 - OBJECTIVES: There are few contemporary, prospective multicenter series on the spectrum of acute adverse events and their relationship to long-term outcomes after traumatic spinal cord injury. The goal of this study is to assess the prevalence of adverse events after traumatic spinal cord injury and to evaluate the effects on long-term clinical outcome. DESIGN: Multicenter prospective registry. SETTING: Consortium of 11 university-affiliated medical centers in the North American Clinical Trials Network. PATIENTS: Eight-hundred one spinal cord injury patients enrolled by participating centers. INTERVENTIONS: Appropriate spinal cord injury treatment at individual centers. MEASUREMENTS AND MAIN RESULTS: A total of 2,303 adverse events were recorded for 502 patients (63%). Penalized maximum logistic regression models were fitted to estimate the likelihood of neurologic recovery (ASIA Impairment Scale improvement ≥ 1 grade point) and functional outcomes in subjects who developed adverse events at 6 months postinjury. After accounting for potential confounders, the group that developed adverse events showed less neurologic recovery (odds ratio, 0.55; 95% CI, 0.32-0.96) and was more likely to require assisted breathing (odds ratio, 6.55; 95% CI, 1.17-36.67); dependent ambulation (odds ratio, 7.38; 95% CI, 4.35-13.06) and have impaired bladder (odds ratio, 9.63; 95% CI, 5.19-17.87) or bowel function (odds ratio, 7.86; 95% CI, 4.31-14.32) measured using the Spinal Cord Independence Measure subscores. CONCLUSIONS: Results from this contemporary series demonstrate that acute adverse events are common and are associated with worsened long-term outcomes after traumatic spinal cord injury.

AB - OBJECTIVES: There are few contemporary, prospective multicenter series on the spectrum of acute adverse events and their relationship to long-term outcomes after traumatic spinal cord injury. The goal of this study is to assess the prevalence of adverse events after traumatic spinal cord injury and to evaluate the effects on long-term clinical outcome. DESIGN: Multicenter prospective registry. SETTING: Consortium of 11 university-affiliated medical centers in the North American Clinical Trials Network. PATIENTS: Eight-hundred one spinal cord injury patients enrolled by participating centers. INTERVENTIONS: Appropriate spinal cord injury treatment at individual centers. MEASUREMENTS AND MAIN RESULTS: A total of 2,303 adverse events were recorded for 502 patients (63%). Penalized maximum logistic regression models were fitted to estimate the likelihood of neurologic recovery (ASIA Impairment Scale improvement ≥ 1 grade point) and functional outcomes in subjects who developed adverse events at 6 months postinjury. After accounting for potential confounders, the group that developed adverse events showed less neurologic recovery (odds ratio, 0.55; 95% CI, 0.32-0.96) and was more likely to require assisted breathing (odds ratio, 6.55; 95% CI, 1.17-36.67); dependent ambulation (odds ratio, 7.38; 95% CI, 4.35-13.06) and have impaired bladder (odds ratio, 9.63; 95% CI, 5.19-17.87) or bowel function (odds ratio, 7.86; 95% CI, 4.31-14.32) measured using the Spinal Cord Independence Measure subscores. CONCLUSIONS: Results from this contemporary series demonstrate that acute adverse events are common and are associated with worsened long-term outcomes after traumatic spinal cord injury.

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UR - http://www.scopus.com/inward/citedby.url?scp=85073184828&partnerID=8YFLogxK

U2 - 10.1097/CCM.0000000000003937

DO - 10.1097/CCM.0000000000003937

M3 - Article

VL - 47

SP - e854-e862

JO - Critical care medicine

JF - Critical care medicine

SN - 0090-3493

IS - 11

ER -

ID: 54749991