Abstract:
:It remains unclear whether the benefits of early surgical timing are significant in neurologically complete spinal cord injury (SCI). We wanted to compare the effects of early and late surgical timing on non-neurological outcomes in persons with traumatic complete SCI. All cases of traumatic complete SCI referred to a single institution between 2000 and 2011 were retrospectively reviewed. The occurrence of pneumonia, urinary tract infection (UTI), pressure ulcer (PU), and all other postoperative complications were recorded. Cost of acute hospitalization was calculated for each patient based on administrative data. Patients operated on within 24 h of the trauma were compared with patients operated on later than 24 h after the trauma. The effects of surgical timing on complication rate and cost of hospitalization were adjusted for potential confounding variables using multiple regression analyses. Fifty-five patients were operated on ≤ 24 h from injury and 142 were operated on >24 h from injury. Baseline demographic and clinical variables were comparable between the two groups. Pneumonia, UTI, and the presence of any complications were significantly higher in the group operated on >24 h post-trauma. Cost of hospitalization was higher among patients operated >24h post-trauma (≤ 24 h: 22,828$ vs. >24 h: 29,714$). Surgical timing >24 h was a predictor of pneumonia, UTI, total complications. and higher cost of hospitalization after controlling for other confounding variables. This study shows that surgical decompression and stabilization ≤ 24 h following a complete SCI may be a cost-effective strategy to reduce the postoperative complication rate.
journal_name
J Neurotraumajournal_title
Journal of neurotraumaauthors
Bourassa-Moreau E,Mac-Thiong JM,Feldman DE,Thompson C,Parent Sdoi
10.1089/neu.2013.2957subject
Has Abstractpub_date
2013-09-15 00:00:00pages
1596-601issue
18eissn
0897-7151issn
1557-9042journal_volume
30pub_type
杂志文章abstract::Acute pain is a common symptom experienced after spinal cord injury (SCI). The presence of this pain calls for treatment with analgesics, such as buprenorphine. However, there are concerns that the drug may exert other effects besides alleviation of pain. Among those reported are in vitro changes in gene expression, a...
journal_title:Journal of neurotrauma
pub_type: 杂志文章
doi:10.1089/neu.2007.0502
更新日期:2009-10-01 00:00:00
abstract::A penetrating traumatic brain injury (pTBI) occurs when an object impacts the head with sufficient force to penetrate the skin, skull, and meninges, and inflict injury directly to the brain parenchyma. This type of injury has been notoriously difficult to model in small laboratory animals such as rats or mice. To this...
journal_title:Journal of neurotrauma
pub_type: 杂志文章
doi:10.1089/neu.2011.2182
更新日期:2012-04-10 00:00:00
abstract::The present study tested a hypothesis that early identification of injury severity with quantitative magnetic resonance imaging (MRI) provides biomarkers for predicting increased seizure susceptibility and epileptogenesis after traumatic brain injury (TBI). TBI was induced by lateral fluid percussion injury (FPI) in a...
journal_title:Journal of neurotrauma
pub_type: 杂志文章
doi:10.1089/neu.2012.2815
更新日期:2013-07-15 00:00:00
abstract::Phosphorus 31 magnetic resonance spectroscopy (31P MRS) was used to study noninvasively the intracellular free Mg2+ concentration and cellular bioenergetic state of rat brain in vivo before and after fluid percussion-induced traumatic brain injury of graded severity. Brain injury was induced at four levels: low (1.0 +...
journal_title:Journal of neurotrauma
pub_type: 杂志文章
doi:10.1089/neu.1988.5.315
更新日期:1988-01-01 00:00:00
abstract::Moderate hypothermia may reduce subsequent neuronal damage after traumatic brain injury. Interleukin (IL)-6 may have a role in the pathogenesis of traumatic neuronal damage or repair. Using the enzyme-linked immunological sorbent assay (ELISA), we serially measured IL-6 levels in plasma obtained from the radial artery...
journal_title:Journal of neurotrauma
pub_type: 临床试验,杂志文章
doi:10.1089/neu.1999.16.225
更新日期:1999-03-01 00:00:00
abstract::The development of anxiety disorders after a traumatic brain injury (TBI) is a strong predictor of social, personal, and work dysfunction; nevertheless, the emergence of anxiety has been largely unexplored and poorly understood in the context of TBI. This article provides an overview of the limited published research ...
journal_title:Journal of neurotrauma
pub_type: 杂志文章,评审
doi:10.1089/neu.2014.3504
更新日期:2015-04-01 00:00:00
abstract::Studies have shown reduced life expectancy following moderate-severe traumatic brain injury (TBI) with death from unintentional poisoning (UP) being 11 times higher following TBI than in the general population. The characteristics of those who die of unintentional poisoning are compared with the characteristics of tho...
journal_title:Journal of neurotrauma
pub_type: 杂志文章
doi:10.1089/neu.2020.7038
更新日期:2020-12-01 00:00:00
abstract::Spinal cord injury can have a range of debilitating effects, permanently impacting a patient's quality of life. Initially thought to be an immune privileged site, the spinal cord is able to mount a timely and well organized inflammatory response to injury. Intricate immune cell interactions are triggered, typically co...
journal_title:Journal of neurotrauma
pub_type: 杂志文章,评审
doi:10.1089/neu.2014.3429
更新日期:2014-11-01 00:00:00
abstract::Closed head injury often has a devastating outcome, partly because the insult, like other injuries to the central nervous system (CNS), triggers self-destructive processes. During studies of the response to other CNS insults, it was unexpectedly discovered that the immune system, if well controlled, provides protectio...
journal_title:Journal of neurotrauma
pub_type: 杂志文章
doi:10.1089/089771503767168483
更新日期:2003-06-01 00:00:00
abstract::Rotational acceleration of the head, as occurs in falls, car crashes, and sport injuries, may result in diffuse brain damage, with acute and chronic neurological and psychiatric symptoms. The present study addresses the effects of rotational trauma on the neuronal cytoskeleton, which stabilizes perikaryal, dendritic a...
journal_title:Journal of neurotrauma
pub_type: 杂志文章
doi:10.1089/08977150360547080
更新日期:2003-02-01 00:00:00
abstract::The current lack of diagnostic and prognostic biomarkers for traumatic brain injury (TBI) confounds treatment and management of patients and is of increasing concern as the TBI population grows. We have generated plasma proteomic profiles from mice receiving TBI by controlled cortical impact at either 1.3 mm or 1.8 mm...
journal_title:Journal of neurotrauma
pub_type: 杂志文章
doi:10.1089/neu.2011.1789
更新日期:2012-01-20 00:00:00
abstract::The purpose of this paper is to present results from methodologies used in our laboratory that are targeted toward identifying specific brain injury thresholds. Results from studying one form of brain injury, diffuse axonal injury, are presented in this report. Physical models, or surrogates, of the skull-brain comple...
journal_title:Journal of neurotrauma
pub_type: 杂志文章
doi:10.1089/neu.1995.12.689
更新日期:1995-08-01 00:00:00
abstract::Traumatic brain injury (TBI) is a leading cause of death and functional disability in western countries, affecting mostly young patients. Despite intense and sustained efforts deployed for the development of new therapeutic strategies, no clinical benefit has been shown by any of the investigated compounds. Increasing...
journal_title:Journal of neurotrauma
pub_type: 杂志文章
doi:10.1089/neu.2005.22.345
更新日期:2005-03-01 00:00:00
abstract::Anatomical studies of spinal cord injury (SCI) using magnetic resonance imaging (MRI) report diverging observations, from "no changes" to "tissue atrophy in motor and non-motor regions." These discrepancies among studies can be attributed to heterogeneity in extent, level, and post-injury duration observed within the ...
journal_title:Journal of neurotrauma
pub_type: 杂志文章
doi:10.1089/neu.2018.6040
更新日期:2019-06-15 00:00:00
abstract::Clinicians are often faced with the challenging task of distinguishing between accidental and inflicted pediatric head trauma. There is currently a disparity in the anecdotal case study literature as to what kinds of injuries can occur in children from low height falls. There is also a paucity of material property dat...
journal_title:Journal of neurotrauma
pub_type: 杂志文章
doi:10.1089/neu.2006.23.1222
更新日期:2006-08-01 00:00:00
abstract::Traumatic brain injury (TBI) is frequently complicated by acute lung injury, which is predictive for poor outcome. However, it is unclear whether lung injury develops independently or as a result of mechanical ventilation after TBI. Further, TBI is strongly associated with the development of pneumonia, suggesting a sp...
journal_title:Journal of neurotrauma
pub_type: 杂志文章
doi:10.1089/neu.2013.3060
更新日期:2013-12-15 00:00:00
abstract::Growing evidence suggests that temporally proximal acute concussions and repetitive subconcussive head injuries may lead to long-term neurological deficits. However, the underlying mechanisms of injury and their relative time-scales are not well documented in human injury models. The current study therefore investigat...
journal_title:Journal of neurotrauma
pub_type: 杂志文章
doi:10.1089/neu.2014.3833
更新日期:2015-11-15 00:00:00
abstract::In various animal and human studies, early administration of 17β-estradiol, a strong antioxidant, anti-inflammatory, and anti-apoptotic agent, significantly decreases the severity of injury in the brain associated with cell death. Estrone, the predominant estrogen in postmenopausal women, has been shown to be a promis...
journal_title:Journal of neurotrauma
pub_type: 杂志文章
doi:10.1089/neu.2011.2274
更新日期:2012-08-10 00:00:00
abstract::Clinical and animal studies indicate that hyperthermia during or after traumatic brain injury (TBI) is associated with poor outcome. Alcohol intoxication, a complicating risk factor in many cases of head injury, has been found to both worsen or attenuate posttraumatic neural damage and outcome. The purpose of the pres...
journal_title:Journal of neurotrauma
pub_type: 杂志文章
doi:10.1089/089771502762300256
更新日期:2002-12-01 00:00:00
abstract::Traumatic brain injuries (TBI) are one of the least understood injuries to the body. Finite element (FE) models of the brain have been crucial for understanding concussion and for developing injury mitigation systems; however, the experimental brain deformation data currently used to validate these models are limited....
journal_title:Journal of neurotrauma
pub_type: 杂志文章
doi:10.1089/neu.2017.5362
更新日期:2018-03-01 00:00:00
abstract::Cultured astrocytes, exposed to glutamate at a dose that is generally neurotoxic in vitro (1 mM), exhibit transient swelling in the absence of cell death. In the present study, we further characterize this response by examining the distribution of intermediate filaments and evaluating cellular ultrastructure in primar...
journal_title:Journal of neurotrauma
pub_type: 杂志文章
doi:10.1089/neu.1992.9.255
更新日期:1992-10-01 00:00:00
abstract::There is an urgent need for both the scientific development and clinical validation of novel therapies for acute spinal cord injury (SCI). The scientific development of novel therapies would be facilitated by a better understanding of the acute pathophysiology of human SCI. Clinical validation of such therapies would ...
journal_title:Journal of neurotrauma
pub_type: 临床试验,杂志文章
doi:10.1089/neu.2009.1080
更新日期:2010-04-01 00:00:00
abstract::Traumatic brain injury (TBI) has been identified as a risk factor for Alzheimer's disease (AD). However, how such neural damage contributes to AD pathology remains unclear; specifically, the relationship between the timing of a TBI relative to aging and the onset of AD pathology is not known. In this study, we have ex...
journal_title:Journal of neurotrauma
pub_type: 杂志文章
doi:10.1089/neu.2018.5982
更新日期:2019-06-01 00:00:00
abstract::Information on the nature of deficits and adaptive mechanisms occurring after spinal cord injury is essential to the design of strategies for promoting functional recovery. Motor impairments and compensations were quantified by three-dimensional kinematic analysis in freely walking rats, 6 months after mild cervical (...
journal_title:Journal of neurotrauma
pub_type: 杂志文章
doi:10.1089/neu.2005.22.544
更新日期:2005-05-01 00:00:00
abstract::Despite limited evidence to support the use of amantadine to enhance cognitive function after traumatic brain injury (TBI), the clinical use for this purpose is highly prevalent and is often based on inferred belief systems. The aim of this study was to assess effect of amantadine on cognition among individuals with a...
journal_title:Journal of neurotrauma
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1089/neu.2018.5767
更新日期:2018-10-01 00:00:00
abstract::Previous studies have resulted in conflicting results regarding the predictive effect of various clinical symptoms, signs, and plain imaging for intracranial pathology in adults with minor head injury. We sought to perform a meta-analysis of the literature to assess the significance of these factors for the prediction...
journal_title:Journal of neurotrauma
pub_type: 杂志文章,meta分析
doi:10.1089/0897715041526122
更新日期:2004-07-01 00:00:00
abstract::Post-traumatic epilepsy (PTE) is a consequence of traumatic brain injury (TBI), occurring in 10-25% of patients with moderate to severe injuries. The development of animal models for testing antiepileptogenic therapies and validation of biomarkers to follow epileptogenesis in humans necessitates sophisticated understa...
journal_title:Journal of neurotrauma
pub_type: 杂志文章
doi:10.1089/neu.2013.3221
更新日期:2014-08-15 00:00:00
abstract::The lectin pathway of the complement system has been implicated in secondary ischemic/inflammatory injury after traumatic brain injury (TBI). However, previous experimental studies have yielded conflicting results, and human studies are scarce. In this exploratory study, we investigated associations of several lectin ...
journal_title:Journal of neurotrauma
pub_type: 杂志文章
doi:10.1089/neu.2016.4941
更新日期:2017-09-01 00:00:00
abstract::In human diffuse axonal injury (DAI), axons are exposed to transient tensile strain. Over the ensuing several hours, injured axons enter a "pathological cascade" of events that lead to secondary axotomy. Use of animal models of traumatic axonal injury (TAI) has allowed description of a number of pathological changes b...
journal_title:Journal of neurotrauma
pub_type: 杂志文章
doi:10.1089/neu.1999.16.1225
更新日期:1999-12-01 00:00:00
abstract::Neuroimaging plays an important role in assessing axonal pathology after traumatic spinal cord injury. However, coexisting inflammation confounds imaging assessment of the severity of axonal injury. Herein, we applied diffusion basis spectrum imaging (DBSI) to quantitatively differentiate and quantify underlying patho...
journal_title:Journal of neurotrauma
pub_type: 杂志文章
doi:10.1089/neu.2018.6016
更新日期:2019-08-01 00:00:00