{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T18:50:00Z","timestamp":1791485400399,"version":"4.3.4"},"reference-count":40,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2020,10,1]],"date-time":"2020-10-01T00:00:00Z","timestamp":1601510400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2020,10,1]],"date-time":"2020-10-01T00:00:00Z","timestamp":1601510400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Neurotrauma Reports"],"published-print":{"date-parts":[[2020,10]]},"abstract":"<jats:p>\n                    Recent studies of persons with spinal cord injury (SCI) report higher conversion rates of the American Spinal Injury Association (ASIA) Impairment Scale (AIS) grades, especially for complete injuries. We examined the rate of conversion over time after complete SCI, accounting for demographic and injury characteristics. Subjects were 16 years of age and older with a complete SCI injury between 1995 and 2015, enrolled in the National SCI Database as day-1 admissions. We grouped subjects into 3-year intervals and assessed trends in conversion for the total sample and by tetraplegia (Tetra), high paraplegia (levels T1\u20139, HPara), and low paraplegia (levels T10\u201312, LPara).We used logistic regression to identify factors related to conversion such as age, sex, etiology, and level of injury. Of 2036 subjects, 1876 subjects had a follow-up examination between 30 and 730 days post-injury. Average age at injury was 34.2\u2009\u00b1\u200914.6 years; 79.8% were male, 44.6% Tetra, 35.3% HPara, and 20.1% LPara. There was a strong trend toward increased rates of conversion over time (\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    \u2009&lt;\u20090.01 for all groups), especially for Tetra (to incomplete from 17.6% in 1995\u20131997 to 50% in 2013\u20132015, and to motor incomplete from 9.4% to 28.1%). Conversion rates for Para were less dramatic. There were increased odds of converting to incomplete for year of injury, level of injury (Tetra &gt;LPara &gt;HPara), non-violent etiology, and age (older is better). We found similar factors for conversion to motor incomplete, except sex was significant and etiology was not. Conversion rates from complete to incomplete and motor incomplete injury have been increasing, particularly for persons with tetraplegia. This has implications for acute clinical trials and for prognostication early after SCI.\n                  <\/jats:p>","DOI":"10.1089\/neur.2020.0038","type":"journal-article","created":{"date-parts":[[2020,11,13]],"date-time":"2020-11-13T10:15:17Z","timestamp":1605262517000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":19,"title":["Trends in Rates of ASIA Impairment Scale Conversion in Traumatic Complete Spinal Cord Injury"],"prefix":"10.1177","volume":"1","author":[{"given":"Ralph J.","family":"Marino","sequence":"first","affiliation":[{"name":"Department of Rehabilitation Medicine, Philadelphia, Pennsylvania, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Leff","sequence":"additional","affiliation":[{"name":"Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diana D.","family":"Cardenas","sequence":"additional","affiliation":[{"name":"Department of Physical Medicine and Rehabilitation, University of Miami Miller School of Medicine, Miami, Florida, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jayne","family":"Donovan","sequence":"additional","affiliation":[{"name":"Kessler Institute for Rehabilitation, West Orange, New Jersey, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Physical Medicine and Rehabilitation, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steve","family":"Kirshblum","sequence":"additional","affiliation":[{"name":"Kessler Institute for Rehabilitation, West Orange, New Jersey, USA."},{"name":"Rutgers New Jersey Medical School, Newark, New Jersey, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin E.","family":"Leiby","sequence":"additional","affiliation":[{"name":"Biostatistics Division, Pharmacology and Experimental Therapeutics, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2020,11,13]]},"reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.3171\/2018.10.SPINE18802"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.1089\/neu.2011.1765"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.3171\/2018.9.SPINE18682"},{"key":"e_1_3_4_5_2","first-page":"611","article-title":"Neurological prognosis after traumatic quadriplegia","volume":"50","author":"Maynard F.M.","year":"1979","unstructured":"Maynard F.M., , Reynolds G.G., , Fountain S., , Wilmot C., , and Hamilton R. 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