Journal
NEUROREHABILITATION AND NEURAL REPAIR
Volume 35, Issue 8, Pages 659-662Publisher
SAGE PUBLICATIONS INC
DOI: 10.1177/15459683211023191
Keywords
spinal cord injury; bowel function; prediction; rehabilitation; cohort study; validation
Categories
Funding
- Centro Comunicazione e Ricerca, Collegio Ghislieri, Pavia, Italy
- ERANET-NEURON grant
- Swiss Continence Foundation
- International Foundation for Research in Paraplegia
- Wings for Life
- Deutsche Stiftung Querschnittlahmung.
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This study aimed to validate prediction models for bowel outcomes after traumatic spinal cord injury (SCI). Through validation with an independent sample, the study demonstrated the validity of a simple model in predicting independent and reliable bowel management 1 year after SCI.
Background. The prediction of functional outcomes after spinal cord injury (SCI) is essential to plan the rehabilitation phase and the social reintegration. Recently, 2 models to predict independent and reliable bowel management 1 year after traumatic SCI have been derived and validated in 2 cohorts of patients included in the European Multicenter Study about Spinal Cord Injury (EMSCI). Objective. We aimed to validate 2 prediction models for bowel outcome after traumatic SCI in a patient sample external to EMSCI. Methods. The simplified model (based on a single predictor, the International Standards for Neurological Classification of Spinal Cord Injury [ISNCSCI] total motor score) and the full model (based on 2 predictors, the ISNCSCI total motor score and item 3a of the Spinal Cord Independence Measure) were applied to the retrospectively collected data of 111 patients with traumatic SCI. Results. The simplified and the full models showed excellent discrimination with an area under the receiver operating characteristic curve of .939 (95% confidence interval (CI) .87-1.00) and .922 (95% CI 0.85-.99), respectively. Both models displayed similar results for sensitivity and negative predictive values; however, the simplified model showed higher values for specificity, positive predictive values, and accuracy. The calibration analysis showed a partial overlap between predicted probabilities and observed proportion, with better and acceptable calibration for the simplified model. Conclusions. Using an independent sample, our study demonstrates the validity of a simple model to predict independent and reliable bowel management 1 year after traumatic SCI.
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