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Novel approach to an early assessment of a patient’s potential for neurological remission after acute spinal cord injury: Analysis of hemoglobin concentration dynamics

Context/objective: Examining hemoglobin (Hb) dynamics with regard to the potential of neurological remission in patients with traumatic spinal cord injury (TSCI).Design: Prospective Clinical Observational Study.Setting: BG Trauma Centre Ludwigshafen, Department of Paraplegiology, Rhineland-Palatinat...

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Main Authors: Biglari, Bahram (Author) , Heller, Raban (Author) , Hörner, Manuel (Author) , Sperl, André (Author) , Bock, Tobias (Author) , Reible, Bruno (Author) , Haubruck, Patrick (Author) , Grützner, Paul Alfred (Author) , Moghaddam-Alvandi, Arash (Author)
Format: Article (Journal)
Language:English
Published: 2021
In: The journal of spinal cord medicine
Year: 2021, Volume: 44, Issue: 2, Pages: 229-240
ISSN:2045-7723
DOI:10.1080/10790268.2019.1632060
Online Access:Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1080/10790268.2019.1632060
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Author Notes:Bahram Biglari, Raban Arved Heller, Manuel Hörner, Andre Sperl, Tobias Bock, Bruno Reible, Patrick Haubruck, Paul Alfred Grützner, Arash Moghaddam
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Summary:Context/objective: Examining hemoglobin (Hb) dynamics with regard to the potential of neurological remission in patients with traumatic spinal cord injury (TSCI).Design: Prospective Clinical Observational Study.Setting: BG Trauma Centre Ludwigshafen, Department of Paraplegiology, Rhineland-Palatinate, Germany.Methods: From 2011 to 2017 a total of 80 patients with acute spinal injury were enrolled and divided into three groups: initial neurological impairment either with (G1; n = 33) or without subsequent neurological remission (G0; n = 35) and vertebral fractures without initial neurological impairment as control group (C; n = 12). Blood samples were taken for 3 months at 11 time-points after injury. Analyses were performed using routine diagnostics.Outcome measures: Multiple logistic regression was used to determine the prognostic value of Hb regarding neurological remission respecting clinical covariates.Results: Data showed elevated mean Hb concentrations in G1 from the third day to 1 month compared to G0, Hb levels were significantly higher in G1 after 3 days (P = 0.03, G1 > G0). The final multiple logistic regression model based on this data predicting the presence of neurological remission resulted in an AUC (area under the curve) of 80.5% (CI: 67.8%-93.2%) in the ROC (receiver operating characteristic) analysis.Conclusion: Elevated Hb concentrations are associated with a higher likelihood of neurological remission. Elevated concentrations of Hb in G1 compared to G0 over time might be linked to both a better initial oxygen supply response and a decreased ECM (extracellular matrix) degradation highlighting the role of Hb as a valuable biomarker for neural regeneration after TSCI.
Item Description:Online veröffentlicht: 18. Juni 2019
Gesehen am 07.04.2020
Physical Description:Online Resource
ISSN:2045-7723
DOI:10.1080/10790268.2019.1632060

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