Background. Predicting functional outcomes after traumatic spinal cord injury (SCI) is essential for counseling, rehabilitation planning, and discharge. Moreover, the outcome prognosis is crucial for patient stratification when designing clinical trials. However, no valid prediction rule is currently available for bowel outcomes after a SCI. Objective. To generate a model for predicting the achievement of independent, reliable bowel management at 1 year after traumatic SCI. Methods. We performed multivariable logistic regression analyses of data for 1250 patients with traumatic SCIs that were included in the European Multicenter Study about Spinal Cord Injury. The resulting model was prospectively validated on data for 186 patients. As potential predictors, we evaluated age, sex, and variables from the International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI) and the Spinal Cord Independence Measure (SCIM), measured within 40 days of the injury. A positive outcome at 1 year post-SCI was assessed with item 7 of the SCIM. Results. The model relied on a single predictor, the ISNCSCI total motor score—that is, the sum of muscle strengths in 5 key muscle groups in each limb. The area under the receiver operating characteristics curve (aROC) was 0.837 (95% CI: 0.815-0.859). The prospective validation confirmed high predictive power: aROC = 0.817 (95% CI: 0.754-0.881). Conclusions. We generated a valid model for predicting independent, reliable bowel management at 1 year after traumatic SCI. Its application could improve counseling, optimize patient-tailored rehabilitation planning, and become crucial for appropriate patient stratification in future clinical trials.

中文翻译：

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创伤性脊髓损伤后肠道结果预测：纵向队列研究

背景。预测创伤性脊髓损伤 (SCI) 后的功能结果对于咨询、康复计划和出院至关重要。此外，在设计临床试验时，结果预后对于患者分层至关重要。然而，目前没有有效的预测规则可用于 SCI 后的肠道结果。客观的。生成一个模型，用于预测创伤性 SCI 后 1 年独立、可靠的肠道管理的实现。方法。我们对纳入欧洲脊髓损伤多中心研究的 1250 名创伤性 SCI 患者的数据进行了多变量逻辑回归分析。由此产生的模型对 186 名患者的数据进行了前瞻性验证。作为潜在的预测因素，我们评估了年龄、性别、脊髓损伤神经学分类国际标准 (ISNCSCI) 和脊髓独立性测量 (SCIM) 中的变量，在损伤后 40 天内测量。SCIM 的第 7 项评估了 SCI 后 1 年的阳性结果。结果。该模型依赖于一个单一的预测因子，即 ISNCSCI 总运动评分，即每条肢体 5 个关键肌肉群的肌肉力量总和。受试者工作特征曲线下面积 (aROC) 为 0.837（95% CI：0.815-0.859）。前瞻性验证证实了高预测能力：aROC = 0.817（95% CI：0.754-0.881）。结论。我们生成了一个有效的模型，用于预测创伤性 SCI 后 1 年的独立、可靠的肠道管理。它的应用可以改善咨询，优化为患者量身定制的康复计划，