Association between injury severity scores and clinical outcomes in patients with traumatic spinal injury in an aging Japanese society

Medicine, 2023 · DOI: http://dx.doi.org/10.1097/MD.0000000000035369 · Published: September 1, 2023

Simple Explanation

This study looks at how the Injury Severity Score (ISS) relates to the outcomes of spinal cord injury (SCI) patients in Japan, considering the country's aging population. ISS is a tool used to assess the severity of injuries in patients with multiple injuries. The study found that a higher ISS was associated with lower motor scores, reduced ability to perform daily activities, and lower quality of life. Patients with lower ISS scores were more likely to return home and to work. The researchers suggest that the ISS is an important tool for initially assessing injury and predicting outcomes in SCI patients, especially in the context of an aging society.

Study Duration

January 2011 and December 2021

Participants

89 patients with traumatic SCI

Evidence Level

Not specified

Key Findings

1
The mean ISS was significantly higher for polytrauma than monotrauma.
2
Significant negative correlations between the ISS and ASIA motor scores at the first visit and the last follow-up were observed.
3
The Barthel Index was also negatively correlated with ISS at the first visit and at the last follow-up period.

Research Summary

This study investigated the association between ISS and clinical outcomes in older Japanese patients with SCI. The mean ISS was significantly higher in the polytrauma versus monotrauma group. Barthel Index and ASIA motor scores at admission and the last follow-up as well as EQ5d at the last follow-up were correlated with ISS. The results suggest that the outcomes of the aging society of Japan can be predicted using ISS evaluations at the time of traumatic SCI.

Practical Implications

Clinical Assessment

ISS can be used as an initial assessment method to predict outcomes in patients with SCI.

Rehabilitation Planning

Understanding the correlation between ISS and functional outcomes can help tailor rehabilitation programs.

Resource Allocation

Hospitals can use ISS to allocate resources effectively for SCI patients, considering the potential impact on their ability to return home or work.

Study Limitations

1
The sample consisted of patients at a single emergency and critical care center in Japan and was subject to biased patient selection.
2
The sample size was small, and we could not separately analyze each lesion level or ASIA Impairment Scale grade, as in a previous study.
3
Non-clinical factors, including universal public health and long-term care insurance systems, and welfare services for individuals with disabilities in Japan.

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