Prediction of bowel management independence after ischemic spinal cord injury

European Journal of Physical and Rehabilitation Medicine, 2022 · DOI: 10.23736/S1973-9087.22.07366-X · Published: October 1, 2022

Spinal Cord Injury Gastroenterology Rehabilitation

Simple Explanation

This study focused on predicting bowel management independence in patients with ischemic spinal cord injury (SCI). It used a model previously developed for traumatic SCI to see if it would work for ischemic SCI patients. The study looked at data from 142 patients and used a single predictor: the International Standards for Neurological Classification of Spinal Cord Injury total motor score, measured within 40 days of the injury. The results showed that the model could fairly predict who would achieve independent bowel management one year after the injury.

Study Duration

1 year

Participants

142 patients with ischemic SCI

Evidence Level

Prognostic study – observational study

Key Findings

1
The prediction model showed fair discrimination, with an area under the ROC curve of 0.780 (95% confidence interval=0.702-0.860).
2
The model displayed an acceptable accuracy and calibration, indicating it's reasonably reliable for predicting bowel management independence.
3
65% of the ischemic SCI patients in the study achieved independent bowel management at 1 year post-injury.

Research Summary

The study aimed to evaluate the performance of a prediction model, previously validated for traumatic SCI, in predicting bowel management independence one year after ischemic SCI. The model, based on the ISNCSCI total motor score collected within 40 days from injury, showed fair discrimination and acceptable accuracy and calibration in the ischemic SCI population. The findings suggest that the model can be a valuable tool in clinical practice for counseling patients, defining rehabilitation aims, and estimating the need for assistance after discharge.

Practical Implications

Clinical Counseling

The model can help clinicians counsel patients about their likelihood of achieving bowel management independence after ischemic SCI.

Rehabilitation Planning

The prediction can aid in setting realistic rehabilitation goals and tailoring interventions for individual patients.

Resource Allocation

The model can help estimate the level of assistance needed after discharge, optimizing resource allocation.

Study Limitations

1
The rehabilitative treatments were not standardized among the different EMSCI centers, potentially introducing confounding by center effects.
2
A high number of patients were lost to follow-up, although baseline characteristics were similar between those with and without follow-up data.
3
The model showed a low value of specificity, which implies that a low quote of patients who will not reach independence in bowel management is correctly classified.

Your Feedback

Was this summary helpful?

Back to Spinal Cord Injury