Acute assessment of spinal cord injury in New South Wales: A retrospective study of current practice in two spinal cord injury referral centers

The Journal of Spinal Cord Medicine, 2025 · DOI: 10.1080/10790268.2023.2247625 · Published: August 24, 2023

Simple Explanation

This study looked at how quickly and thoroughly spinal cord injuries are assessed in two major hospitals in New South Wales (NSW), Australia. The researchers reviewed the medical records of patients admitted with acute spinal cord injuries to see if neurological assessments were done according to established guidelines within 72 hours of the injury. The study found that in most cases, these assessments were not done quickly enough, which could make it harder to track recovery and plan the best treatments.

Study Duration

2 Years

Participants

97 patients with acute traumatic spinal cord injury

Evidence Level

Not specified

Key Findings

1
Only 18% of patients had a neurological examination documented according to the ISNCSCI within 72 h of injury.
2
At the first neurological examination the neurological level of injury and American Spinal Injury Association Injury Scale (AIS) grade was unable to be determined or not performed in 26.8% of patients and 29.9% of patients respectively
3
Time to the first completed neurological examination was shorter at POWH with median of 4.9 days compared to 12.4 days at RNSH.

Research Summary

This retrospective study evaluated the acute assessment of spinal cord injuries (SCI) in two referral centers in New South Wales (NSW). The study revealed that neurological assessments, as per ISNCSCI guidelines, are often delayed beyond the recommended 72-hour window, potentially hindering prognostication and treatment evaluation. The findings underscore the need for improved adherence to guidelines and more timely neurological assessments to optimize SCI management and research.

Practical Implications

Improved Adherence to Guidelines

Healthcare providers should prioritize early and accurate neurological assessments following spinal cord injury, adhering to established ISNCSCI guidelines.

Standardization of Assessment Protocols

Hospitals and trauma centers should implement standardized protocols for the acute assessment of SCI, including clear timelines and designated personnel responsible for neurological examinations.

Enhanced Data Collection and Registries

Establishment of comprehensive SCI registries and databases is essential for tracking outcomes, evaluating treatment effectiveness, and facilitating research efforts aimed at improving SCI management.

Study Limitations

1
Retrospective design
2
Medical record was often deficient when interpreting and assessing the completeness of the neurological examination.
3
Does not reveal the systematic differences that may cause delays.

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