Neurological outcomes following spinal cord injury (SCI) are currently difficult to predict. While the initial American Spinal Injury Association Impairment Scale (AIS) grade can give an estimate of outcome, the high remaining degree of uncertainty has stoked recent interest in biomarkers for SCI. This study aimed to assess the prognostic value of routinely measured blood biomarkers by developing prognostic models of AIS scores at discharge and 12 months post-injury. Routine blood and clinical data were collected from SCI patients (n = 417), and blood measures that had been assessed in less than 50% of patients were excluded. Outcome neurology was obtained from AIS and Spinal Cord Independence Measure III (SCIM-III) scores at discharge and 12 months post-injury, with motor (AIS) and sensory (AIS, touch and prick) abilities being assessed individually. Linear regression models with and without elastic net penalization were created for all outcome measures. Blood measures associated with liver function, such as alanine transaminase, were found to add value to predictions of SCIM-III at discharge and 12 months post-injury. Further, components of a total blood count, including hemoglobin, were found to add value to predictions of AIS motor and sensory scores at discharge and 12 months post-injury. These findings corroborate the results of our previous preliminary study and thus provide further evidence that routine blood measures can add prognostic value in SCI and that markers of liver function are of particular interest.

中文翻译：

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常规测量的血液学标志物可以帮助预测脊髓损伤后美国脊髓损伤协会损伤量表评分

目前很难预测脊髓损伤（SCI）后的神经系统结果。虽然最初的美国脊柱损伤协会损伤量表 (AIS) 等级可以对结果进行估计，但仍存在高度的不确定性，最近引起了人们对 SCI 生物标志物的兴趣。本研究旨在通过开发出院时和受伤后 12 个月的 AIS 评分预后模型来评估常规测量的血液生物标志物的预后价值。收集 SCI 患者 ( n  = 417) 的常规血液和临床数据，并排除了在不到 50% 的患者中评估的血液测量结果。神经病学结果通过出院时和受伤后 12 个月的 AIS 和脊髓独立测量 III (SCIM-III) 评分获得，并单独评估运动 (AIS) 和感觉（AIS、触觉和刺痛）能力。为所有结果指标创建了具有和不具有弹性净惩罚的线性回归模型。研究发现，与肝功能相关的血液检测（例如丙氨酸转氨酶）可以为出院时和受伤后 12 个月的 SCIM-III 预测增加价值。此外，还发现包括血红蛋白在内的全血细胞计数成分可以为出院时和受伤后 12 个月的 AIS 运动和感觉评分的预测增加价值。这些发现证实了我们之前的初步研究结果，从而提供了进一步的证据，证明血常规测量可以增加 SCI 的预后价值，并且肝功能标志物特别令人感兴趣。