Zinc Concentration Dynamics Indicate Neurological Impairment Odds after Traumatic Spinal Cord Injury
Abstract
:1. Introduction
2. Materials and Methods
2.1. Source of Data
2.2. Participants
2.3. Outcome
2.4. Predictors
2.5. Sample Size
2.6. Missing Data
2.7. Related Work
2.8. Statistical Analysis
3. Results
3.1. Demographics
3.2. Analysis of the Entire Patient Collective
3.3. Comparison of Serum Zn Concentrations in Relation to Neurological Remission
3.4. Zn in Neurological Patients in Relation to Controls with Vertebral Fractures
3.5. Comparison within the Group of Recovering Patients in Relation to Impairment
3.6. Comparison of Zn Concentration Dynamics from Admission to 9 h after Injury
4. Discussion
4.1. Limitations
4.2. Strengths
5. Conclusions
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
References
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Variable | All (N = 42) | G0 (N = 15) | G1 (N = 18) | C (N = 9) | p-Value |
---|---|---|---|---|---|
Sex | 0.56 | ||||
female | 12 (29) | 2 (13) | 5 (28) | 5 (56) | |
male | 30 (71) | 13 (87) | 13 (72) | 4 (44) | |
Age | 0.17 | ||||
min | 15 | 20 | 15 | 27 | |
max | 78 | 78 | 75 | 71 | |
median (IQR) | 42.00 (27.75, 59.00) | 49 (35.50, 62.00) | 37.50 (21.25, 57.00) | 40 (32.00, 59.00) | |
mean (95% CI) | 44.07 (38.35, 49.80) | 48.60 (38.77, 58.43) | 39.33 (30.18, 48.48) | 46.00 (35.66, 56.34) | |
Etiology | 0.74 | ||||
Fall from height | 21 (50) | 6 (40) | 9 (50) | 6 (67) | |
Motor vehicle collision | 16 (38) | 6 (40) | 7 (39) | 3 (33) | |
Other accident | 5 (12) | 3 (20) | 2 (11) | 0 (0) | |
AO | 0.17 | ||||
A | 29 (69) | 8 (53) | 15 (83) | 6 (67) | |
B | 6 (14) | 2 (13) | 1 (6) | 3 (33) | |
C | 7 (17) | 5 (33) | 2 (11) | 0 (0) | |
NLI | 0.04 | ||||
none | 9 (21) | 0 (0) | 0 (0) | 9 (100) | |
cervical | 14 (33) | 4 (27) | 10 (56) | 0 (0) | |
thoracical | 14 (33) | 10 (67) | 4 (22) | 0 (0) | |
lumbar | 5 (12) | 1 (7) | 4 (22) | 0 (0) | |
AIS initial | < 0.01 | ||||
A | 15 (36) | 12 (80) | 3 (17) | 0 (0) | |
B | 7 (17) | 1 (7) | 6 (33) | 0 (0) | |
C | 10 (24) | 1 (7) | 9 (50) | 0 (0) | |
D | 1 (2) | 1 (7) | 0 (0) | 0 (0) | |
E | 9 (21) | 0 (0) | 0 (0) | 9 (100) | |
AIS final | < 0.01 | ||||
A | 12 (29) | 12 (80) | 0 (0) | 0 (0) | |
B | 3 (7) | 1 (7) | 2 (11) | 0 (0) | |
C | 6 (14) | 1 (7) | 5 (28) | 0 (0) | |
D | 12 (29) | 1 (7) | 11 (61) | 0 (0) | |
E | 9 (21) | 0 (0) | 0 (0) | 9 (100) |
AIS Grade | A | B | C | D | E |
---|---|---|---|---|---|
Clinical State | Complete no motor or sensory function is preserved in the sacral segments S4–S5 | Incomplete sensory but not motor function is preserved below the NLI and includes the sacral segments S4–S5 | Incomplete motor function is preserved below the NLI, and more than half of key muscles below the NLI have a muscle grade less than 3 | Incomplete motor function is preserved below the NLI, and at least half of key muscles below the NLI have a muscle grade of 3 or more | Normal motor and sensory function is normal |
Variable | Model 1 | Model 2 | Model 3 | Cohen’s d |
---|---|---|---|---|
(Intercept) | 1.37 ** | 1.15 * | 1.20 * | |
[0.50, 2.24] | [0.22, 2.09] | [0.02, 2.38] | ||
Zn 0 h (µg/L) | 0.68 | −0.632 | ||
[−0.27, 1.63] | moderate | |||
Zn 9 h (µg/L) | −0.75 | 0.636 | ||
[−1.69, 0.20] | moderate | |||
Zn 0 h–9 h (µg/L) | 1.28 | −1.12 | ||
[−0.07, 2.63] | large | |||
n | 36 | 27 | 21 | |
AIC | 39.88 | 32.16 | 24.45 | |
Pseudo-R² (Cragg-Uhler) | 0.09 | 0.14 | 0.29 |
Variable | Data of the Current Study (N = 14) | Kijima et al., 2019 (N = 38) [23] | p-Value |
---|---|---|---|
Sex | > 0.99 | ||
female | 3 (21.4%) | 10 (26.3%) | |
male | 11 (78.6%) | 28 (73.7%) | |
Age | < 0.01 | ||
min | 15.00 | 18.00 | |
max | 77.00 | 85.00 | |
median (IQR) | 47.50 (15.00, 77.00) | 67.50 (18.00, 85.00) | |
mean (95% CI) | 45.43(33.98, 56.88) | 63.579 (57.61, 69.55) | |
Etiology | 0.23 | ||
Fall from height | 4 (28.6%) | 15 (39.5%) | |
Motor vehicle collision | 8 (57.1%) | 12 (31.6%) | |
Other accident | 2 (14.3%) | 11 (28.9%) | |
AIS initial | 0.18 | ||
A | 4 (28.6%) | 13 (34.2%) | |
B | 4 (28.6%) | 3 (7.9%) | |
C | 5 (35.7%) | 10 (26.3%) | |
D | 1 (7.1%) | 8 (21.1%) | |
E | 0 (0.0%) | 4 (10.5%) | |
AIS final | 0.79 | ||
A | 3 (21.4%) | 6 (15.8%) | |
B | 1 (7.1%) | 3 (7.9%) | |
C | 3 (21.4%) | 8 (21.1%) | |
D | 7 (50.0%) | 17 (44.7%) | |
E | 0 (0.0%) | 4 (10.5%) |
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Heller, R.A.; Sperl, A.; Seelig, J.; Haubruck, P.; Bock, T.; Werner, T.; Besseling, A.; Sun, Q.; Schomburg, L.; Moghaddam, A.; et al. Zinc Concentration Dynamics Indicate Neurological Impairment Odds after Traumatic Spinal Cord Injury. Antioxidants 2020, 9, 421. https://doi.org/10.3390/antiox9050421
Heller RA, Sperl A, Seelig J, Haubruck P, Bock T, Werner T, Besseling A, Sun Q, Schomburg L, Moghaddam A, et al. Zinc Concentration Dynamics Indicate Neurological Impairment Odds after Traumatic Spinal Cord Injury. Antioxidants. 2020; 9(5):421. https://doi.org/10.3390/antiox9050421
Chicago/Turabian StyleHeller, Raban Arved, André Sperl, Julian Seelig, Patrick Haubruck, Tobias Bock, Theresa Werner, Albert Besseling, Qian Sun, Lutz Schomburg, Arash Moghaddam, and et al. 2020. "Zinc Concentration Dynamics Indicate Neurological Impairment Odds after Traumatic Spinal Cord Injury" Antioxidants 9, no. 5: 421. https://doi.org/10.3390/antiox9050421