Journal CME August 2024, Concomitant traumatic brain injury as a determinant of survival, and neurological and functional outcomes after traumatic spinal cord injury: A retrospective cohort study-PM R - 2023 - Furlan - Concomitant traumatic brain injury as a determinant

PM R - 2023 - Furlan - Concomitant traumatic brain injury as a determinant

Pdf Summary

A retrospective cohort study conducted by Julio C. Furlan and colleagues investigated the impact of concomitant mild-to-moderate traumatic brain injury (TBI) on survival, neurological, and functional outcomes within the first year after acute traumatic spinal cord injury (SCI). The study utilized data from the Third National Spinal Cord Injury Study (NASCIS-3), involving 499 individuals. Participants were divided into two groups: those with SCI alone (SCI-alone group) and those with both SCI and TBI (SCI + TBI group).<br /><br />Key findings include:<br />1. **Demographics and Injury Characteristics**: The SCI + TBI group comprised 17.2% of the study population, was older, and had a higher proportion of complete and cervical SCIs than the SCI-alone group. This group also displayed higher blood alcohol levels.<br /><br />2. **Survival Rates**: There was no significant difference in the survival rate within the first year between the SCI + TBI group (93.0%) and the SCI-alone group (93.6%).<br /><br />3. **Neurological and Functional Outcomes**:<br />    - **Neurological Recovery**: The SCI + TBI group had lower initial motor, sensory, and pain scores. However, after one year, concomitant mild-to-moderate TBI did not significantly impact neurological outcomes (motor, sensory, and pain scores) when adjusted for major potential confounders.<br />    - **Functional Recovery**: Functional outcomes assessed using the Functional Independence Measure (FIM) showed that the SCI + TBI group consistently had lower scores than the SCI-alone group. Despite this, multiple regression analyses indicated that concomitant TBI did not significantly affect functional outcomes when adjustments for major potential confounders were made.<br /><br />The study concludes that concomitant mild-to-moderate TBI does not significantly impact survival, neurological recovery, or functional outcomes at one year after SCI. The epidemiological differences between individuals with SCI alone and those with both SCI and TBI were noted, but the overall influence of mild-to-moderate TBI on recovery metrics was minimal. The findings highlight the need for further research to explore the interplay between TBI and SCI across different contexts and definitions.

Keywords

retrospective cohort study

Julio C. Furlan

traumatic brain injury

spinal cord injury

NASCIS-3

neurological outcomes

functional outcomes

survival rates

epidemiological differences

recovery metrics