OBJECTIVE: Acute spinal cord injury (SCI) can result in debilitating motor, sensory, and autonomic dysfunction. As a treatment option, therapeutic hypothermia has been researched to inadequate pharmaceutical treatment, except for methylprednisolone. In this article, we systematically meta-analyzed to clarify the effect of hypothermia in acute SCI on neurological outcomes. METHODS: The PubMed, Embase, Web of Science, and Cochrane clinical trial databases were systematically searched until June 30, 2022. The proportion of cases with improved neurological status after hypothermia in acute SCI were pooled with a random-effects model. Subgroup analyses for the method of hypothermia and injury level were conducted. RESULTS: Eight studies with a total of 103 patients were included. Hypothermia in acute SCI improved neurological function by 55.8% (95% confidence interval [CI]: 39.4%-72.1%). The subgroup analysis revealed that the pooled proportion of cases showing neurological improvement was higher with systemic hypothermia (70.9%) (95% CI, 14.9%-100%) than with local hypothermia (52.5%) (95% CI, 40.4%-64.5%), although the subgroup difference was not statistically significant (p = 0.53). Another subgroup analysis revealed that the proportion of cases with neurological improvement did not differ statistically between the cervical spine (61.4%) (95% CI, 42.2%-80.6%) and thoracic spine injury groups (59.4%) (95% CI, 34.8%-84.0%) (p = 0.90). CONCLUSION: This meta-analysis identified that more than 50% of patients showed neurological improvement after hypothermia following acute SCI in general. A multicenter, randomized, double-blind study with larger sample size is necessary to validate the findings further.
OBJECTIVE: Acute spinal cord injury (SCI) can result in debilitating motor, sensory, and autonomic dysfunction. As a treatment option, therapeutic hypothermia has been researched to inadequate pharmaceutical treatment, except for methylprednisolone. In this article, we systematically meta-analyzed to clarify the effect of hypothermia in acute SCI on neurological outcomes. METHODS: The PubMed, Embase, Web of Science, and Cochrane clinical trial databases were systematically searched until June 30, 2022. The proportion of cases with improved neurological status after hypothermia in acute SCI were pooled with a random-effects model. Subgroup analyses for the method of hypothermia and injury level were conducted. RESULTS: Eight studies with a total of 103 patients were included. Hypothermia in acute SCI improved neurological function by 55.8% (95% confidence interval [CI]: 39.4%-72.1%). The subgroup analysis revealed that the pooled proportion of cases showing neurological improvement was higher with systemic hypothermia (70.9%) (95% CI, 14.9%-100%) than with local hypothermia (52.5%) (95% CI, 40.4%-64.5%), although the subgroup difference was not statistically significant (p = 0.53). Another subgroup analysis revealed that the proportion of cases with neurological improvement did not differ statistically between the cervical spine (61.4%) (95% CI, 42.2%-80.6%) and thoracic spine injury groups (59.4%) (95% CI, 34.8%-84.0%) (p = 0.90). CONCLUSION: This meta-analysis identified that more than 50% of patients showed neurological improvement after hypothermia following acute SCI in general. A multicenter, randomized, double-blind study with larger sample size is necessary to validate the findings further.
Authors: Karthik Madhavan; David M Benglis; Michael Y Wang; Steve Vanni; Nathan Lebwohl; Barth A Green; Allan D Levi Journal: Ther Hypothermia Temp Manag Date: 2012-12 Impact factor: 1.286
Authors: Aditya Vedantam; George Jimsheleishvili; James S Harrop; Linda R Alberga; Faiz U Ahmad; Rory K Murphy; J Benjamin Jackson; Richard B Rodgers; Allan D Levi Journal: Spinal Cord Date: 2022-01-10 Impact factor: 2.473
Authors: Jonathan Ac Sterne; Miguel A Hernán; Barnaby C Reeves; Jelena Savović; Nancy D Berkman; Meera Viswanathan; David Henry; Douglas G Altman; Mohammed T Ansari; Isabelle Boutron; James R Carpenter; An-Wen Chan; Rachel Churchill; Jonathan J Deeks; Asbjørn Hróbjartsson; Jamie Kirkham; Peter Jüni; Yoon K Loke; Theresa D Pigott; Craig R Ramsay; Deborah Regidor; Hannah R Rothstein; Lakhbir Sandhu; Pasqualina L Santaguida; Holger J Schünemann; Beverly Shea; Ian Shrier; Peter Tugwell; Lucy Turner; Jeffrey C Valentine; Hugh Waddington; Elizabeth Waters; George A Wells; Penny F Whiting; Julian Pt Higgins Journal: BMJ Date: 2016-10-12
Authors: Marios C Papadopoulos; Samira Saadoun; Mathew J Gallagher; Florence R A Hogg; Siobhan Kearney; Marcel A Kopp; Christian Blex; Leonarda Serdani; Oliver Sherwood; Jan M Schwab; Argyro Zoumprouli Journal: Sci Rep Date: 2020-05-15 Impact factor: 4.379
Authors: Seth C Ransom; Nolan J Brown; Zachary A Pennington; Nikita Lakomkin; Anthony L Mikula; Mohamad Bydon; Benjamin D Elder Journal: J Clin Med Date: 2022-03-13 Impact factor: 4.241