An Evaluation of International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI) Performance Within the Canadian SCI Network.

To describe the performance of the International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI) examination in individuals with traumatic spinal cord injury (TSCI) and nontraumatic spinal cord injury (NTSCI) across Canadian acute and rehabilitation facilities, evaluating t...

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Publicado en:Topics in Spinal Cord Injury Rehabilitation Vol. 31; no. 3; pp. 15 - 37
Autores principales: Hong, Heather A., Parsons, Jessica, Xu, Jijie, Walden, Kristen, Fallah, Nader, Cheng, Christiana L., Attabib, Najmedden, Christie, Sean D., Craven, B. Catharine, Fehlings, Michael G., Fourney, Daryl R., Ho, Chester, Julien, Lisa, Kwon, Brian K., Linassi, Gary A., Loyola-Sanchez, Adalberto, Moganathas, Saranjan, Paquet, Jerome, Sreenivasan, Vidya, Mac-Thiong, Jean-Marc
Formato: research tables/charts Journal Article
Publicado: KnowledgeWorks Global, Ltd Summer2025
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Summer2025
      vid: 31
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      pub: KnowledgeWorks Global, Ltd
      place: Richmond, Virginia
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        atl: An Evaluation of International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI) Performance Within the Canadian SCI Network.
      aug:
        au:
          Hong, Heather A.
          Parsons, Jessica
          Xu, Jijie
          Walden, Kristen
          Fallah, Nader
          Cheng, Christiana L.
          Attabib, Najmedden
          Christie, Sean D.
          Craven, B. Catharine
          Fehlings, Michael G.
          Fourney, Daryl R.
          Ho, Chester
          Julien, Lisa
          Kwon, Brian K.
          Linassi, Gary A.
          Loyola-Sanchez, Adalberto
          Moganathas, Saranjan
          Paquet, Jerome
          Sreenivasan, Vidya
          Mac-Thiong, Jean-Marc
        affil: Praxis Spinal Cord Institute, Vancouver, British Columbia, Canada
      sug:
        subj:
          Spinal Cord Injuries Classification
          Spinal Cord Injuries Organizations
          Neurologic Examination Standards
          Acute Care
          Rehabilitation Centers
          Time Factors
          Outcome Assessment
          Human
          Funding Source
          Canada
          Male
          Female
          Middle Age
          Spinal Cord Injuries Diagnosis
          Spinal Cord Injuries Physiopathology
          International Agencies
          Protocols
          Patient Care Evaluation
          Quality of Health Care
          Neurologic Examination Methods
          Registries, Disease
          Prospective Studies
          Patient Admission
          Patient Discharge
          Algorithms
          Clinical Assessment Tools
          Bivariate Statistics
          Age Factors
          Severity of Injury
          Length of Stay
          Pain
          Retrospective Design
          Hospitalization
          Comparative Studies
          Descriptive Statistics
          T-Tests
          Wilcoxon Rank Sum Test
          Chi Square Test
          Fisher's Exact Test
          Data Analysis Software
          Data Analysis, Statistical
          Medical Records
          Documentation
          Middle Aged: 45-64 years
          Male
          Female
      ab: To describe the performance of the International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI) examination in individuals with traumatic spinal cord injury (TSCI) and nontraumatic spinal cord injury (NTSCI) across Canadian acute and rehabilitation facilities, evaluating timing, completeness, and classification accuracy. Using the Rick Hansen Spinal Cord Injury Registry (2015-2022), participants were analyzed across 6 cohorts: (A) TSCI-acute-admission (n = 4461), (B) TSCI-acute-discharge (n = 972), (C) TSCI-rehabilitation-admission (n = 2673), (D) TSCI-rehabilitation-discharge (n = 2316), (E) NTSCI-rehabilitation-admission (n = 728), and (F) NTSCI-rehabilitation-discharge (n = 619). ISNCSCI data included performed (yes/no), timing (≤72 hours, ≤7 days, and >7 days of admission/discharge), completeness, missing items, and worksheet used (yes/no). Classification accuracy between the clinician-determined and algorithm-generated ASIA Impairment Scale and neurological level of injury classification was evaluated. Descriptive and bivariate statistics were used to analyze cohorts. Overall, 70% of participants had at least one examination performed, with 76% performed ≤72 hours, 91% ≤7 days, and 9% >7 days. However, 45% were partially complete, primarily missing sensory scores and rectal components ≤7 days. Comparison of TSCI and NTSCI during rehabilitation showed that NTSCI cohorts had significantly more exams at admission and fewer at discharge, with more complete exams. Moreover, age at injury, injury type, mechanism, severity, length of stay, and pain influenced examination performance. This study highlights the need for greater consistency in ISNCSCI examination performance and identifies patient-level barriers to completion. Determining the most effective standardized approach for ISNCSCI use across SCI care, addressing modifiable human/organizational factors, and ensuring comprehensive clinical training will improve the quality of this assessment.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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