دورية أكاديمية
Predictors of outcome in a large retrospective cohort of patients with transverse myelitis
| العنوان: | Predictors of outcome in a large retrospective cohort of patients with transverse myelitis |
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| المؤلفون: | Gastaldi, M, Marchioni, E, Banfi, P, Mariani, V, Di Lodovico, L, Bergamaschi, R, Alfonsi, E, Borrelli, P, Ferraro, O, Zardini, E, Pichiecchio, A, Cortese, A, Waters, P, Woodhall, M, Ceroni, M, Mauri, M, Franciotta, D |
| بيانات النشر: | SAGE Publications |
| سنة النشر: | 2018 |
| المجموعة: | Oxford University Research Archive (ORA) |
| الوصف: | Background Transverse myelitis (TM) is an inflammatory disorder of the spinal cord that can be idiopathic, or associated with demyelinating diseases, collagen vascular diseases, or post-infectious syndromes. Uncertainty exists on the prognosis of initial TM presentations. We aimed to identify outcome predictors in this pathology. Methods This is a retrospective study on patients with isolated TM as the first manifestation of neurological disorders. Scores ≥3 on the modified Rankin scale (mRS) marked high disability. Results 159 patients (mean age, 47 years; 43% female) were identified and, at the end of follow-up (mean time, 62.2 months), TM was classified as follows: idiopathic (I-TM, n=53), post-infectious (PI-TM, n=48), associated with multiple sclerosis (MS-TM, n=51), or to neuromyelitis optica spectrum disorder/collagen vascular disease/neurosarcoidosis (n=7). At follow-up, 42 patients were severely disabled, and patients with I-TM or PI-TM showed the worst outcomes (Mean mRS score 2.2 (PI-TM) v 1.6 (I-TM) v 0.7 (MS-TM), p<0.001). Predictors of disability at onset were: infectious antecedents, sphincteric and pyramidal symptoms, high initial mRS scores, presence of blood-cerebrospinal fluid-barrier damage, and lumbosacral MRI lesions (on univariate analysis), and older age (odds ratio (OR), 1.1; 95%CI, 1.0-1.1), overt/subclinical involvement of the peripheral nervous system (PNS) (OR, 9.4; 95%CI, 2.2-41.0), complete TM (OR, 10.8; 95%CI, 3.4-34.5) on multivariate analysis. Conclusions Our findings help define prognosis and therapeutic choices in the first manifestations of TM. Notably, infectious antecedents and the PNS involvement associate with a severe prognosis. TM thorough prognostic assessment should include neurophysiology, nerve conduction studies and lumbosacral MRI. |
| نوع الوثيقة: | article in journal/newspaper |
| اللغة: | English |
| العلاقة: | https://ora.ox.ac.uk/objects/uuid:dbb607bb-77c9-4ec5-a248-339e97ed4185Test; https://doi.org/10.1177/1352458517731911Test |
| DOI: | 10.1177/1352458517731911 |
| الإتاحة: | https://doi.org/10.1177/1352458517731911Test https://ora.ox.ac.uk/objects/uuid:dbb607bb-77c9-4ec5-a248-339e97ed4185Test |
| حقوق: | info:eu-repo/semantics/openAccess |
| رقم الانضمام: | edsbas.4679513F |
| قاعدة البيانات: | BASE |
| DOI: | 10.1177/1352458517731911 |
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