here is a detailed study regarding
spinal cord injury prognosis done by ncbi.
Prognosis
In 2008, Ditunno et al published the results of a panel study in which the priorities for recovery of independent functional activities after tSCI were questioned.28 Recovery preferences for bladder and bowel function were the highest, closely followed by recovery of walking. In clinical practice, one of the most prominent questions patients and their families ask during the early days after the injury is: “Will I (he/she) ever be able to walk again?” Until recently, physicians experienced the greatest difficulties in answering this question accurately. Recent advances in clinical SCI research have led to the introduction of valuable tools for the prediction of functional outcomes after tSCI.
Recently, Goodwin-Wilson et al introduced the use of “evidence-based process maps” for SCI
rehabilitation.29 In these process maps, the range of daily activities of patients with a specified severity (AIS) and level of injury are presented for each week postinjury. Using this method, physicians are able to provide patients with a framework for expected short-, intermediate- and long-term outcomes. This benchmarking approach is not only for the benefit of patients with tSCI, it also provides a better insight into the complete rehabilitation process for health care professionals. For optimal applicability of the process maps, it is important to determine the severity and level of the injury accurately prior to the start of the rehabilitation program.
Although a broad range of functional outcomes are of interest in the tSCI population, the prognostication of ambulation outcomes have been studied most intensively.9 The severity of the injury is the principal prognostic factor for the prediction of ambulation outcomes after tSCI. In clinical practice, the distinction between “complete” and “incomplete” SCI is commonly made to express the injury’s severity. However, van Middendorp et al recently demonstrated that this distinction results in a suboptimal prediction for ambulation outcomes after tSCI.4 A more nuanced method for the prediction of ambulation outcomes can be achieved with use of the ASIA/ISCoS neurological standard scale (see Table 2 ). With use of the AIS grades, more accurate predictions can be made than with distinction between a “complete” and an “incomplete” injury ( Table 3 ).4 30 As can be discerned from Table 3 , patients with AIS grades A and D have the smallest (8.3%) and biggest (97.3%) probability of being able to walk independently 1 year after the injury, respectively. On the contrary, the variability of the probable ambulation outcomes in patients with AIS grades B and C remains relatively high.31
Providing a solution to the suboptimal accuracy of the two mentioned approaches, a novel, simple, and highly accurate prediction rule for independent ambulation outcomes after tSCI was published in 2011.32 The prediction rule consists of five prognostic parameters: age (
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