Catherine Jutzeler1,2,3, John L K Kramer4,5, Anh K Vo1,6, Fred Geisler7, Lukas Grassner8,9,10, Jan Schwab11, Gale Whiteneck12. 1. International Collaboration on Repair Discoveries (ICORD), University of British Columbia, Vancouver, BC, Canada. 2. Spinal Cord Injury Center, University Hospital Balgrist, Zurich, Switzerland. 3. Department of Biosystems Science and Engineering, ETH Zurich, 4058, Basel, Switzerland. 4. International Collaboration on Repair Discoveries (ICORD), University of British Columbia, Vancouver, BC, Canada. kramer@icord.org. 5. School of Kinesiology, University of British Columbia, Vancouver, BC, Canada. kramer@icord.org. 6. School of Kinesiology, University of British Columbia, Vancouver, BC, Canada. 7. University of Saskatchewan, Saskatoon, SK, Canada. 8. Center for Spinal Cord Injuries, BG Trauma Center Murnau, Murnau, Germany. 9. Department of Neurosurgery, Medical University Innsbruck, Innsbruck, Austria. 10. Institute of Molecular Regenerative Medicine, Spinal Cord Injury and Tissue Regeneration Center Salzburg, Paracelsus Medical University Salzburg, Salzburg, Austria. 11. Belford Center for Spinal Cord Injury and Department of Neurology (Paraplegiology), Wexner Medical Center, The Ohio State University, Columbus, OH, USA. 12. Craig Hospital, Research Department, Englewood, CO, USA.
Abstract
STUDY DESIGN: This was a secondary analysis on an observational cohort study. OBJECTIVE: To determine if serum albumin significantly associates with long-term neurological outcome (i.e., 1-year post-injury) in a contemporary cohort of individuals with spinal cord injury. SETTING: Six rehabilitation centers across the United States. METHODS: A secondary analysis of neurological outcomes and serum albumin concentrations was performed on data from the Spinal Cord Injury Rehabilitation study. Data was accessed from the Archive of Data on Disability to Enable Policy and research (ADDEP). The primary analysis applied unbiased recursive partitioning to examine the relationship between serum albumin, injury severity, and long-term outcomes. The analysis is accessible via https://rpubs.com/AnhKhoaVo/586028 . RESULTS: Serum albumin concentration was significantly associated with lower extremity motor scores (LEMS) and American Spinal Injury Association Impairment Scale (AIS) grade at admission to rehabilitation. Serum albumin concentrations alone were also significantly associated with change of LEMS and marked recovery (improvement of at least 2 AIS grades and/or recovery to walking) at 1-year post injury. However, after adjusting for admission to rehabilitation LEMS and AIS grade, serum albumin was not significant. CONCLUSION: The current study partially confirms our previous observations that serum albumin concentrations are associated with neurological outcome after spinal cord injury. As a crude prognostic biomarker, serum albumin concentration could be useful in cases where injury severity cannot be accurately assessed.
STUDY DESIGN: This was a secondary analysis on an observational cohort study. OBJECTIVE: To determine if serum albumin significantly associates with long-term neurological outcome (i.e., 1-year post-injury) in a contemporary cohort of individuals with spinal cord injury. SETTING: Six rehabilitation centers across the United States. METHODS: A secondary analysis of neurological outcomes and serum albumin concentrations was performed on data from the Spinal Cord Injury Rehabilitation study. Data was accessed from the Archive of Data on Disability to Enable Policy and research (ADDEP). The primary analysis applied unbiased recursive partitioning to examine the relationship between serum albumin, injury severity, and long-term outcomes. The analysis is accessible via https://rpubs.com/AnhKhoaVo/586028 . RESULTS:Serum albumin concentration was significantly associated with lower extremity motor scores (LEMS) and American Spinal Injury Association Impairment Scale (AIS) grade at admission to rehabilitation. Serum albumin concentrations alone were also significantly associated with change of LEMS and marked recovery (improvement of at least 2 AIS grades and/or recovery to walking) at 1-year post injury. However, after adjusting for admission to rehabilitation LEMS and AIS grade, serum albumin was not significant. CONCLUSION: The current study partially confirms our previous observations that serum albumin concentrations are associated with neurological outcome after spinal cord injury. As a crude prognostic biomarker, serum albumin concentration could be useful in cases where injury severity cannot be accurately assessed.