{
  "abstract": "Background Treatment of blunt traumatic spinal cord injuries (SCIs) often includes maintaining elevated mean arterial blood pressures (MAP) to enhance perfusion to the spinal cord. Optimal hyperperfusion protocols and treatment algorithms have yet to be delineated due to a paucity of large volume prospective studies. This study aims to identify predictors of neurological improvement in American Spinal Injury Association (ASIA) impairment score following blunt SCI.Study design Prospective (January 10, 2021 to June 1, 2023) multicenter study included blunt SCI patients age >18 with complete neurological examination documented on hospital arrival. Patients were divided into two groups: neurological improvement and no improvement, based on their change in ASIA score from arrival to hospital discharge.Results A total of 19 centers contributed 222 patients of those, 164 had pre-ASIA and post-ASIA scores. The ASIA improvement group had 36 patients (22%). There was no statistical difference in the median percentage of time patients spent at a MAP >85 mm Hg during treatment 80.7% (IQR 63.6, 93.4) no improvement vs 83.6% (IQR 70.1, 93.0) in the improvement, (p=0.87). There was no difference in the median duration of MAP treatment in hours between the groups (95.6 hours (IQR 62.55, 113.48) in the no improvement group versus 96 (IQR 72, 113.5) (p=0.40) in the improvement group).Conclusions Overall, 22% of all blunt SCI patients saw an improvement in their ASIA score. Adherence to and length of MAP augmentation was not a statistically significantly different between groups.Level of evidence Level IV Therapeutic/Care Management.",
  "authors": [
    {
      "affiliations": [
        "OhioHealth, Columbus, Ohio, USA"
      ],
      "name": "Aimee LaRiccia"
    },
    {
      "affiliations": [
        "OhioHealth, Columbus, Ohio, USA"
      ],
      "name": "Stephanie Doris"
    },
    {
      "affiliations": [
        "OhioHealth, Columbus, Ohio, USA"
      ],
      "name": "Bhairav Shah"
    },
    {
      "affiliations": [
        "OhioHealth, Columbus, Ohio, USA"
      ],
      "name": "Tanisha Kashikar"
    },
    {
      "affiliations": [
        "Surgery, Inova Fairfax Medical Center, Falls Church, Virginia, USA"
      ],
      "name": "Erik Teicher"
    },
    {
      "affiliations": [
        "Surgery, Division of Trauma and Acute Care Surgery, Lancaster General Health, Lancaster, Pennsylvania, USA"
      ],
      "name": "Lindsey Perea"
    },
    {
      "affiliations": [
        "Lancaster General Health, Lancaster, Pennsylvania, USA"
      ],
      "name": "Jennifer Huber"
    },
    {
      "affiliations": [
        "Queen’s Medical Center, Honolulu, Hawaii, USA"
      ],
      "name": "Malia Eischen"
    },
    {
      "affiliations": [
        "Queen’s Medical Center, Honolulu, Hawaii, USA"
      ],
      "name": "H Akin Erol"
    },
    {
      "affiliations": [
        "Surgery, University of California San Francisco, San Francisco, California, USA",
        "Surgery, Zuckerberg San Francisco General Hospital and Trauma Center, San Francisco, California, USA"
      ],
      "name": "Michael Steven Farrell"
    },
    {
      "affiliations": [
        "Lehigh Valley Health Network, Allentown, Pennsylvania, USA"
      ],
      "name": "Lauren Colom"
    },
    {
      "affiliations": [
        "The University of Tennessee Medical Center, Knoxville, Tennessee, USA"
      ],
      "name": "Stephanie Scott"
    },
    {
      "affiliations": [
        "Surgical Critical Care, University of Tennessee Medical Center, Knoxville, Tennessee, USA"
      ],
      "name": "Brian Daley"
    },
    {
      "affiliations": [
        "Trauma, Acute Care and Critical Care, West Virginia University Robert C Byrd Health Sciences Center, Morgantown, West Virginia, USA"
      ],
      "name": "James Bardes"
    },
    {
      "affiliations": [
        "Trauma, Acute Care Surgery and Critical Care, West Virginia University Health Sciences Center, Morgantown, West Virginia, USA"
      ],
      "name": "Gregory Schaefer"
    },
    {
      "affiliations": [
        "Trauma, Kettering Health Main Campus, Kettering, Ohio, USA"
      ],
      "name": "Melissa Moncrief"
    },
    {
      "affiliations": [
        "Riverside Methodist Hospital, Columbus, Ohio, USA"
      ],
      "name": "William DeVoe"
    },
    {
      "affiliations": [
        "UT Southwestern Medical, Dallas, Texas, USA"
      ],
      "name": "Ryan Peter Dumas"
    },
    {
      "affiliations": [
        "East Carolina University, Greenville, North Carolina, USA"
      ],
      "name": "Caitlin Anne Fitzgerald"
    },
    {
      "affiliations": [
        "Cook County Health, Chicago, Illinois, USA"
      ],
      "name": "William Brigode"
    },
    {
      "affiliations": [
        "Trauma Surgery, Broward Health Medical Center, Fort Lauderdale, Florida, USA"
      ],
      "name": "John D Berne"
    },
    {
      "affiliations": [
        "Trauma Serevices, Broward Health, Fort Lauderdale, Florida, USA"
      ],
      "name": "Dalier R Mederos"
    },
    {
      "affiliations": [
        "Surgery, Penn State Health Milton S Hershey Medical Center, Hershey, Pennsylvania, USA"
      ],
      "name": "Scott Armen"
    },
    {
      "affiliations": [
        "Surgery, Penn State Health Milton S Hershey Medical Center, Hershey, Pennsylvania, USA"
      ],
      "name": "Melissa Linskey Dougherty"
    },
    {
      "affiliations": [
        "Trauma, ChristianaCare, Wilmington, Delaware, USA"
      ],
      "name": "Asanthi Ratnasekera"
    },
    {
      "affiliations": [
        "Trauma, ChristianaCare, Wilmington, Delaware, USA"
      ],
      "name": "Emily Alberto"
    },
    {
      "affiliations": [
        "Trauma, Critical Care and Acute Care Surgery, Louisiana State University Medical Center, Shreveport, Louisiana, USA"
      ],
      "name": "Alison Smith"
    },
    {
      "affiliations": [
        "Sugery, Vanderbilt University Medical Center, Nashville, Tennessee, USA"
      ],
      "name": "Bradley M Dennis"
    },
    {
      "affiliations": [
        "Vanderbilt University Medical Center, Nashville, Tennessee, USA"
      ],
      "name": "Stephen Gadomski"
    },
    {
      "affiliations": [
        "UC Irvine Healthcare, Orange, California, USA"
      ],
      "name": "Jeffry Nahmias"
    },
    {
      "affiliations": [
        "UC Irvine Healthcare, Orange, California, USA"
      ],
      "name": "Claudia Alvarez"
    },
    {
      "affiliations": [
        "Cooper University Hospital Regional Trauma Center, Camden, New Jersey, USA"
      ],
      "name": "Salina Wydo"
    },
    {
      "affiliations": [
        "Cooper University Hospital Regional Trauma Center, Camden, New Jersey, USA"
      ],
      "name": "Jennifer Schweinsburg"
    },
    {
      "affiliations": [
        "South Texas Health System, Edinburg, Texas, USA"
      ],
      "name": "Carlos H Palacio"
    },
    {
      "affiliations": [
        "Trauma and Surgical Critical Care, Mount Carmel Hospital, Columbus, Ohio, USA"
      ],
      "name": "M Chance Spalding"
    },
    {
      "affiliations": [
        "OhioHealth, Columbus, Ohio, USA"
      ],
      "name": "Joshua Hill"
    }
  ],
  "title": "Does mean arterial pressure augmentation improve neurological recovery of blunt spinal cord injuries: an EAST multicenter trial",
  "uid": "33bda395-447c-50b4-b947-71250ba86b00"
}