{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T09:21:21Z","timestamp":1777713681000,"version":"3.51.4"},"reference-count":46,"publisher":"American Spinal Injury Association","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020]]},"abstract":"\n Objectives:<\/jats:title>\n To investigate the relationship between early trauma indicators and neurologic recovery after traumatic SCI using standardized outcome measures from the ISNCSCI examination and standardized functional outcome measures for rehabilitation populations.<\/jats:p>\n <\/jats:sec>\n \n Methods:<\/jats:title>\n This is a retrospective review of merged, prospectively collected, multicenter data from the Spinal Cord Injury Model Systems (SCIMS) database and institutional trauma databases from five academic medical centers across the United States. Functional status at inpatient rehabilitation discharge and change in severity and level of injury from initial SCI to inpatient rehabilitation discharge were analyzed to assess neurologic recovery for patients with traumatic SCI. Linear and logistic regression with multiple imputation were used for the analyses.<\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n A total of 209 patients were identified. Mean age at injury was 47.2 \u00b1 18.9 years, 72.4% were male, 22.4% of patients had complete injuries at presentation to the emergency department (ED), and most patients were admitted with cervical SCI. Mean systolic blood pressure (SBP) was 124.1 \u00b1 29.6 mm Hg, mean ED heart rate was 83.7 \u00b1 19.9 bpm, mean O2 saturation was 96.8% \u00b1 4.0%, and mean Glasgow Coma Scale (GCS) score was 13.3 \u00b1 3.9. The average Injury Severity Score (ISS) in this population was 22.4. Linear regression analyses showed that rehabilitation discharge motor FIM was predicted by motor FIM on admission and ISS. Requiring ventilatory support on ED presentation was negatively associated with improvement of ASIA Impairment Scale (AIS) grade at rehabilitation discharge compared with AIS grade after initial injury. Emergency room physiologic measures (SBP, pulse, oxygen saturation) did not predict discharge motor FIM or improvement in AIS grade or neurological level of injury.<\/jats:p>\n <\/jats:sec>\n \n Conclusion:<\/jats:title>\n Our study showed a positive association between discharge FIM and ISS and a negative association between ventilatory support at ED presentation and AIS improvement. The absence of any significant association between other physiologic or clinical variables at ED presentation with rehabilitation outcomes suggests important areas for future clinical research.<\/jats:p>\n <\/jats:sec>","DOI":"10.46292\/sci20-00017","type":"journal-article","created":{"date-parts":[[2021,1,29]],"date-time":"2021-01-29T14:25:27Z","timestamp":1611930327000},"page":"253-260","source":"Crossref","is-referenced-by-count":6,"title":["Early Trauma Indicators and Rehabilitation Outcomes in Traumatic Spinal Cord Injury"],"prefix":"10.46292","volume":"26","author":[{"given":"Chloe","family":"Slocum","sequence":"first","affiliation":[{"name":"Harvard Medical School, Boston, Massachusetts"},{"name":"Spaulding Rehabilitation Hospital, Boston, Massachusetts"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cristina","family":"Shea","sequence":"additional","affiliation":[{"name":"Harvard Medical School, Boston, Massachusetts"},{"name":"Spaulding Rehabilitation Hospital, Boston, Massachusetts"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Richard","family":"Goldstein","sequence":"additional","affiliation":[{"name":"Harvard Medical School, Boston, Massachusetts"},{"name":"Spaulding Rehabilitation Hospital, Boston, Massachusetts"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ross","family":"Zafonte","sequence":"additional","affiliation":[{"name":"Harvard Medical School, Boston, Massachusetts"},{"name":"Spaulding Rehabilitation Hospital, Boston, Massachusetts"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"25425","reference":[{"issue":"2","key":"i1082-0744-26-4-253-b1","series-title":"Spinal Cord","first-page":"95","article-title":"Quality of life, social participation, appraisals and coping post spinal cord injury: A review of four community samples","volume":"44","year":"2006","unstructured":"Kennedy\n P,\n \n \n Lude\n P,\n \n \n Taylor\n N.\n \n \n Quality of life, social participation, appraisals and coping post spinal cord injury: A review of four community samples.\n\t\t\t\t\tSpinal Cord.\n\t\t\t\t\t2006;\n\t\t\t\t\t44(\n\t\t\t\t\t2):\n\t\t\t\t\t95\u2013\n\t\t\t\t\t105."},{"issue":"24 suppl","key":"i1082-0744-26-4-253-b2","series-title":"Spine (Phila Pa 1976)","first-page":"S137","article-title":"Establishing prognosis and maximizing functional outcomes after spinal cord injury: A review of current and future directions in rehabilitation management","volume":"26","year":"2001","unstructured":"Burns\n AS,\n \n \n Ditunno\n JF.\n \n \n Establishing prognosis and maximizing functional outcomes after spinal cord injury: A review of current and future directions in rehabilitation management.\n\t\t\t\t\tSpine (Phila Pa 1976).\n\t\t\t\t\t2001;\n\t\t\t\t\t26(\n\t\t\t\t\t24 suppl):\n\t\t\t\t\tS137\u2013\n\t\t\t\t\t145."},{"issue":"15","key":"i1082-0744-26-4-253-b3","series-title":"J Neurotrauma","first-page":"1705","article-title":"Early predictors of global functional 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https:\/\/www.facs.org\/-\/media\/files\/quality-programs\/trauma\/ntdb\/ntdb-annual-report-2016.ashx"},{"issue":"2","key":"i1082-0744-26-4-253-b6","series-title":"J Trauma","first-page":"291","article-title":"Hypotension begins at 110 mm Hg: Redefining \u201chypotension\u201d with data","volume":"63","year":"2007","unstructured":"Eastridge\n BJ,\n \n \n Salinas\n J,\n \n \n McManus\n JG,\n \n \n .\n\t\t\t\t\tHypotension begins at 110 mm Hg: Redefining \u201chypotension\u201d with data.\n\t\t\t\t\tJ Trauma.\n\t\t\t\t\t2007;\n\t\t\t\t\t63(\n\t\t\t\t\t2):\n\t\t\t\t\t291\u2013\n\t\t\t\t\t297;\n\t\t\t\t\tdiscussion 297\u2013299."},{"issue":"1","key":"i1082-0744-26-4-253-b7","series-title":"Ann Emerg Med","doi-asserted-by":"publisher","first-page":"62","DOI":"10.1016\/j.annemergmed.2016.08.007","article-title":"The effect of combined out-of-hospital hypotension and hypoxia on mortality in major traumatic brain injury","volume":"69","year":"2017","unstructured":"Spaite\n DW,\n \n \n Hu\n C,\n \n \n Bobrow\n BJ,\n \n \n .\n\t\t\t\t\tThe effect of combined out-of-hospital hypotension and hypoxia on mortality in major traumatic brain injury.\n\t\t\t\t\tAnn Emerg Med.\n\t\t\t\t\t2017;\n\t\t\t\t\t69(\n\t\t\t\t\t1):\n\t\t\t\t\t62\u2013\n\t\t\t\t\t72.\n\t\t\t\t\tdoi: 10.1016\/j.annemergmed.2016.08.007"},{"issue":"11","key":"i1082-0744-26-4-253-b8","series-title":"Med J Aust","first-page":"657","article-title":"Respiratory rate: The neglected vital sign","volume":"188","year":"2008","unstructured":"Cretikos\n MA,\n \n \n Bellomo\n R,\n \n \n Hillman\n K,\n \n \n Chen\n J,\n \n \n Finfer\n S,\n \n \n Flabouris\n A.\n \n \n Respiratory rate: The neglected vital sign.\n\t\t\t\t\tMed J Aust.\n\t\t\t\t\t2008;\n\t\t\t\t\t188(\n\t\t\t\t\t11):\n\t\t\t\t\t657\u2013\n\t\t\t\t\t659."},{"key":"i1082-0744-26-4-253-b9","series-title":"Scand J Trauma Resusc Emerg Med","first-page":"21","article-title":"The association between vital signs and mortality in a retrospective cohort study of an unselected emergency department population","volume":"24","year":"2016","unstructured":"Ljunggren\n M,\n \n \n Castr\u00e9n\n M,\n \n \n Nordberg\n M,\n \n \n Kurland\n L.\n \n \n The association between vital signs and mortality in a retrospective cohort study of an unselected emergency department population.\n\t\t\t\t\tScand J Trauma Resusc Emerg Med.\n\t\t\t\t\t2016;\n\t\t\t\t\t24:\n\t\t\t\t\t21."},{"issue":"10","key":"i1082-0744-26-4-253-b10","series-title":"Neural Regen Res","first-page":"1618","article-title":"Interactions of primary insult biomechanics and secondary cascades in spinal cord injury: Implications for therapy","volume":"12","year":"2017","unstructured":"Orr\n MB,\n \n \n Gensel\n JC.\n \n \n Interactions of primary insult biomechanics and secondary cascades in spinal cord injury: Implications for therapy.\n\t\t\t\t\tNeural Regen 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https:\/\/www.nscisc.uab.edu\/Public_Pages\/Database_files\/What_Is_The_National_SCIMS_Database.pdf"},{"issue":"2","key":"i1082-0744-26-4-253-b13","series-title":"Neurosurgery","first-page":"281","article-title":"Civilian gunshot wounds to the spinal cord and cauda equina","volume":"20","year":"1987","unstructured":"Benzel\n EC,\n \n \n Hadden\n TA,\n \n \n Coleman\n JE.\n \n \n Civilian gunshot wounds to the spinal cord and cauda equina.\n\t\t\t\t\tNeurosurgery.\n\t\t\t\t\t1987;\n\t\t\t\t\t20(\n\t\t\t\t\t2):\n\t\t\t\t\t281\u2013\n\t\t\t\t\t285."},{"issue":"2","key":"i1082-0744-26-4-253-b14","series-title":"Top Spinal Cord Inj Rehabil","first-page":"186","article-title":"Surgical and nonsurgical treatment of penetrating spinal cord injury: Analysis of long-term neurological and functional outcomes","volume":"25","year":"2019","unstructured":"Kelly\n ML,\n \n \n Roach\n MJ,\n \n \n Nemunaitis\n G,\n \n \n Chen\n Y.\n \n \n Surgical and nonsurgical treatment of penetrating spinal cord injury: Analysis of long-term neurological and functional outcomes.\n\t\t\t\t\tTop Spinal Cord Inj Rehabil.\n\t\t\t\t\t2019;\n\t\t\t\t\t25(\n\t\t\t\t\t2):\n\t\t\t\t\t186\u2013\n\t\t\t\t\t193."},{"issue":"4","key":"i1082-0744-26-4-253-b15","series-title":"PM R","first-page":"314","article-title":"Early predictors of functional outcome after trauma","volume":"8","year":"2016","unstructured":"Nemunaitis\n G,\n \n \n Roach\n MJ,\n \n \n Claridge\n J,\n \n \n Mejia\n M.\n \n \n Early predictors of functional outcome after trauma.\n\t\t\t\t\tPM R.\n\t\t\t\t\t2016;\n\t\t\t\t\t8(\n\t\t\t\t\t4):\n\t\t\t\t\t314\u2013\n\t\t\t\t\t320."},{"key":"i1082-0744-26-4-253-b16","series-title":"J Spinal Cord Med.","article-title":"Current practices and goals for mean arterial pressure and spinal cord perfusion pressure in acute traumatic spinal cord injury: Defining the gaps in knowledge [published online September 16, 2019]","unstructured":"Menacho\n ST,\n \n \n Floyd\n C.\n \n \n Current practices and goals for mean arterial pressure and spinal cord perfusion pressure in acute traumatic spinal cord injury: Defining the gaps in knowledge [published online September 16, 2019].\n\t\t\t\t\tJ Spinal Cord Med."},{"issue":"24","key":"i1082-0744-26-4-253-b17","series-title":"J Neurotrauma","first-page":"1958","article-title":"Mean arterial blood pressure correlates with neurological recovery after human spinal cord injury: Analysis of high frequency physiologic data","volume":"32","year":"2015","unstructured":"Hawryluk\n G,\n \n \n Whetstone\n W,\n \n \n Saigal\n R,\n \n \n .\n\t\t\t\t\tMean arterial blood pressure correlates with neurological recovery after human spinal cord injury: Analysis of high frequency physiologic data.\n\t\t\t\t\tJ Neurotrauma.\n\t\t\t\t\t2015;\n\t\t\t\t\t32(\n\t\t\t\t\t24):\n\t\t\t\t\t1958\u2013\n\t\t\t\t\t1967."},{"issue":"16","key":"i1082-0744-26-4-253-b18","series-title":"Neurology","first-page":"1660","article-title":"Spinal cord perfusion pressure predicts neurologic recovery in acute spinal cord injury","volume":"89","year":"2017","unstructured":"Squair\n JW,\n \n \n B\u00e9langer\n LM,\n \n \n Tsang\n A,\n \n \n .\n\t\t\t\t\tSpinal cord perfusion pressure predicts neurologic recovery in acute spinal cord injury.\n\t\t\t\t\tNeurology.\n\t\t\t\t\t2017;\n\t\t\t\t\t89(\n\t\t\t\t\t16):\n\t\t\t\t\t1660\u2013\n\t\t\t\t\t1667."},{"issue":"2","key":"i1082-0744-26-4-253-b19","series-title":"J Emerg Trauma Shock","first-page":"94","article-title":"Increased mean arterial pressure goals after spinal cord injury and functional outcome","volume":"8","year":"2015","unstructured":"Martin\n ND,\n \n \n Kepler\n C,\n \n \n Zubair\n M,\n \n \n Sayadipour\n A,\n \n \n Cohen\n M,\n \n \n Weinstein\n M.\n \n \n Increased mean arterial pressure goals after spinal cord injury and functional outcome.\n\t\t\t\t\tJ Emerg Trauma 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pressure signal predicts outcome after spinal cord injury","volume":"9","year":"2018","unstructured":"Chen\n S,\n \n \n Gallagher\n MJ,\n \n \n Papadopoulos\n MC,\n \n \n Saadoun\n S.\n \n \n Non-linear dynamical analysis of intraspinal pressure signal predicts outcome after spinal cord injury.\n\t\t\t\t\tFront Neurol.\n\t\t\t\t\t2018;\n\t\t\t\t\t9:\n\t\t\t\t\t493."},{"issue":"2","key":"i1082-0744-26-4-253-b1","series-title":"Spinal Cord","first-page":"95","article-title":"Quality of life, social participation, appraisals and coping post spinal cord injury: A review of four community samples","volume":"44","year":"2006","unstructured":"Kennedy\n P,\n \n \n Lude\n P,\n \n \n Taylor\n N.\n \n \n Quality of life, social participation, appraisals and coping post spinal cord injury: A review of four community samples.\n\t\t\t\t\tSpinal Cord.\n\t\t\t\t\t2006;\n\t\t\t\t\t44(\n\t\t\t\t\t2):\n\t\t\t\t\t95\u2013\n\t\t\t\t\t105."},{"issue":"24 suppl","key":"i1082-0744-26-4-253-b2","series-title":"Spine (Phila Pa 1976)","first-page":"S137","article-title":"Establishing prognosis and maximizing functional outcomes after spinal cord injury: A review of current and future directions in rehabilitation management","volume":"26","year":"2001","unstructured":"Burns\n AS,\n \n \n Ditunno\n JF.\n \n \n Establishing prognosis and maximizing functional outcomes after spinal cord injury: A review of current and future directions in rehabilitation management.\n\t\t\t\t\tSpine (Phila Pa 1976).\n\t\t\t\t\t2001;\n\t\t\t\t\t26(\n\t\t\t\t\t24 suppl):\n\t\t\t\t\tS137\u2013\n\t\t\t\t\t145."},{"issue":"15","key":"i1082-0744-26-4-253-b3","series-title":"J Neurotrauma","first-page":"1705","article-title":"Early predictors of global functional outcome after traumatic spinal cord injury: A systematic review","volume":"35","year":"2018","unstructured":"Richard-Denis\n A,\n \n \n Beaus\u00e9jour\n M,\n \n \n Thompson\n C,\n \n \n Nguyen\n BH,\n \n \n Mac-Thiong\n JM.\n \n \n Early predictors of global functional outcome after traumatic spinal cord injury: A systematic review.\n\t\t\t\t\tJ Neurotrauma.\n\t\t\t\t\t2018;\n\t\t\t\t\t35(\n\t\t\t\t\t15):\n\t\t\t\t\t1705\u2013\n\t\t\t\t\t1725."},{"key":"i1082-0744-26-4-253-b4","series-title":"Facts and Figures at a Glance.","year":"2019","unstructured":"National Spinal Cord Injury Statistical Center.\n\t\t\t\t\tFacts and Figures at a Glance.Birmingham, AL:\n\t\t\t\t\tUniversity of Alabama at Birmingham,\n\t\t\t\t\t2019."},{"key":"i1082-0744-26-4-253-b5","series-title":"National Trauma Data Bank 2016 Annual Report.","year":"2016","unstructured":"National Trauma Data Bank.\n \n \n National Trauma Data Bank 2016 Annual Report.\n \n 2016. https:\/\/www.facs.org\/-\/media\/files\/quality-programs\/trauma\/ntdb\/ntdb-annual-report-2016.ashx"},{"issue":"2","key":"i1082-0744-26-4-253-b6","series-title":"J Trauma","first-page":"291","article-title":"Hypotension begins at 110 mm Hg: Redefining \u201chypotension\u201d with data","volume":"63","year":"2007","unstructured":"Eastridge\n BJ,\n \n \n Salinas\n J,\n \n \n McManus\n JG,\n \n \n .\n\t\t\t\t\tHypotension begins at 110 mm Hg: Redefining \u201chypotension\u201d with data.\n\t\t\t\t\tJ Trauma.\n\t\t\t\t\t2007;\n\t\t\t\t\t63(\n\t\t\t\t\t2):\n\t\t\t\t\t291\u2013\n\t\t\t\t\t297;\n\t\t\t\t\tdiscussion 297\u2013299."},{"issue":"1","key":"i1082-0744-26-4-253-b7","series-title":"Ann Emerg Med","doi-asserted-by":"publisher","first-page":"62","DOI":"10.1016\/j.annemergmed.2016.08.007","article-title":"The effect of combined out-of-hospital hypotension and hypoxia on mortality in major traumatic brain injury","volume":"69","year":"2017","unstructured":"Spaite\n DW,\n \n \n Hu\n C,\n \n \n Bobrow\n BJ,\n \n \n .\n\t\t\t\t\tThe effect of combined out-of-hospital hypotension and hypoxia on mortality in major traumatic brain injury.\n\t\t\t\t\tAnn Emerg Med.\n\t\t\t\t\t2017;\n\t\t\t\t\t69(\n\t\t\t\t\t1):\n\t\t\t\t\t62\u2013\n\t\t\t\t\t72.\n\t\t\t\t\tdoi: 10.1016\/j.annemergmed.2016.08.007"},{"issue":"11","key":"i1082-0744-26-4-253-b8","series-title":"Med J Aust","first-page":"657","article-title":"Respiratory rate: The neglected vital sign","volume":"188","year":"2008","unstructured":"Cretikos\n MA,\n \n \n Bellomo\n R,\n \n \n Hillman\n K,\n \n \n Chen\n J,\n \n \n Finfer\n S,\n \n \n Flabouris\n A.\n \n \n Respiratory rate: The neglected vital sign.\n\t\t\t\t\tMed J Aust.\n\t\t\t\t\t2008;\n\t\t\t\t\t188(\n\t\t\t\t\t11):\n\t\t\t\t\t657\u2013\n\t\t\t\t\t659."},{"key":"i1082-0744-26-4-253-b9","series-title":"Scand J Trauma Resusc Emerg Med","first-page":"21","article-title":"The association between vital signs and mortality in a retrospective cohort study of an unselected emergency department population","volume":"24","year":"2016","unstructured":"Ljunggren\n M,\n \n \n Castr\u00e9n\n M,\n \n \n Nordberg\n M,\n \n \n Kurland\n L.\n \n 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