Development of a Dynamic Nomogram for Predicting the Probability of Satisfactory Recovery after 6 Months for Cervical Traumatic Spinal Cord Injury

Orthopaedic Surgery, 2023 · DOI: 10.1111/os.13679 · Published: April 1, 2023

Spinal Cord Injury Research Methodology & Design

Simple Explanation

Cervical traumatic spinal cord injury (CTSCI) is a seriously disabling disease that severely affects the physical and mental health of patients and imposes a huge economic burden on patients and their families. Accurate identiﬁcation of the prognosis of CTSCI patients helps clinicians to design individualized treatment plans for patients. A dynamic nomogram was developed to predict the recovery of CTSCI patients after 6 months.

Study Duration

March 2013 and January 2022

Participants

475 patients with CTSCI

Evidence Level

Not specified

Key Findings

1
The multivariate logistic regression model further screened out six independent factors that impact the recovery of patients with CTSCI.
2
These factors included admission to the American Spinal Injury Association Impairment Scale (AIS) grade, the length of high signal in the spinal cord, maximum spinal cord compression (MSCC), spinal segment fractured, admission time, and hormonal therapy within 8 h after injury.
3
In the training cohort, the AUC of the nomogram that included these predictors was 0.879, while in the test cohort, it was 0.824.

Research Summary

The nomogram, including ASIA grade, the length of high signal in the spinal cord, MSCC, spinal segment fractured, admission time, and hormonal therapy within 8 h after injury, is a promising model to predict the probability of content recovery in patients with CTSCI. This nomogram assists clinicians in stratifying patients with CTSCI, enhancing evidence-based decision-making, and individualizing the most appropriate treatment. Overall, the nomogram developed by our team to predict the probability of satisfactory neurological recovery in CTSCI patients is of excellent practical value.

Practical Implications

Personalized Treatment Plans

The nomogram allows clinicians to stratify patients and provide them with personalized treatment plans.

Improved Patient Satisfaction

The nomogram can improve patient satisfaction with treatment.

Enhanced Clinician-Patient Relationship

The nomogram can enhance the relationship between patients and clinicians.

Study Limitations

1
All the patients in our study were from southeastern China, and the sample size was not large enough to represent the entire population of China and Asia.
2
In this study, patients with CTSCI were followed up for only 6 months, which may be too short a follow-up period.
3
Our inclusion of inﬂuencing factors did not include all potential factors associated with the prognosis of patients with CTSCI.

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