Evidence map›Paper›PMID 37480505›Full record

SynthesisActa neurochirurgica2023

In-hospital mortality rate in subaxial cervical spinal cord injury patients: a systematic review and meta-analysis.

Mohsen Sadeghi-Naini, Mahmoud Yousefifard, Zahra Ghodsi, Amir Azarhomayoun, Fatemeh Kermanian, Mehdi Golpayegani, Seyed Danial Alizadeh, Mostafa Hosseini, Farhad Shokraneh, Khalil Komlakh and 4 more

Abstract readMeta-AnalysisSystematic Review
PubMed Publisher
In one paragraph

Synthesis in Acta neurochirurgica, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Review
  3. Article
  4. Management of traumatic spinal cord injury in the Nordic countries: a multidisciplinary survey.Scandinavian journal of trauma, resuscitation and emergency medicine · 2025
    Article
  5. Article
  6. Article
  7. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors.

Mohsen Sadeghi-NainiDepartment of Neurosurgery, Lorestan University of Medical Sciences, Khoram-Abad, Iran.
Mahmoud YousefifardPhysiology Research Center, Iran University of Medical Sciences, Tehran, Iran.
Zahra GhodsiSina Trauma and Surgery Research Center, Tehran University of Medical Science, Tehran, Iran.
Amir AzarhomayounSina Trauma and Surgery Research Center, Tehran University of Medical Science, Tehran, Iran.
Fatemeh KermanianDepartment of Anatomy, Alborz University of Medical Sciences, Karaj, Iran.
Mehdi GolpayeganiSina Trauma and Surgery Research Center, Tehran University of Medical Science, Tehran, Iran.
Seyed Danial AlizadehSina Trauma and Surgery Research Center, Tehran University of Medical Science, Tehran, Iran.
Mostafa HosseiniDepartment of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
Farhad ShokranehKing's Technology Evaluation Centre (KiTEC), School of Biomedical Engineering and Imaging Sciences, Faculty of Life Sciences and Medicine, London Institute of Healthcare Engineering, King's College London, London, UK.
Khalil KomlakhDepartment of Neurosurgery, Imam Hossein Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Alexander R VaccaroDepartment of Orthopedics and Neurosurgery, Thomas Jefferson University and the Rothman Institute, Philadelphia, PA, USA.
Fan JiangDepartment of Surgery and Spine Program, University of Toronto, Toronto Western Hospital, University Health Network, Toronto, ON, Canada.
Michael G FehlingsDepartment of Surgery, University of Toronto, Toronto, Canada.
Vafa Rahimi-MovagharSina Trauma and Surgery Research Center, Tehran University of Medical Science, Tehran, Iran. v_rahimi@sina.tums.ac.ir.ORCID http://orcid.org/0000-0001-7347-8767

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeTo determine existing trends concerning in-hospital mortality in patients with traumatic subaxial cervical spinal cord injury (SCI) over the last four decades.

methodsWe searched MEDLINE and EMBASE to assess the role of the following factors on in-hospital mortality over the last four decades: neurological deficit, age, surgical decompression, use of computed tomography (CT) and magnetic resonance imaging (MRI), use of methylprednisolone in the acute post-injury period, and study location (developing versus developed countries).

resultsAmong 3333 papers after deduplication, 21 studies met the eligibility criteria. The mortality rate was 17.88% [95% confidence interval (CI): 12.9-22.87%]. No significant trend in mortality rate was observed over the 42-year period (meta-regression coefficient = 0.317; p = 0.372). Subgroup analysis revealed no significant association between acute subaxial cervical SCI-related mortality when stratified by use of surgery, administration of methylprednisolone, use of MRI and CT imaging, study design (prospective versus retrospective study), and study location. The mortality rate was significantly higher in complete SCI (20.66%, p = 0.002) and American Spinal Injury Association impairment scale (AIS) A (20.57%) and B (9.28%) (p = 0.028).

conclusionA very low level of evidence showed that in-hospital mortality in patients with traumatic subaxial cervical SCI did not decrease over the last four decades despite diagnostic and therapeutic advancements. The overall acute mortality rate following subaxial cervical SCI is 17.88%. We recommend reporting a stratified mortality rate according to key factors such as treatment paradigms, age, and severity of injury in future studies.

Indexed as

Cervical CordNeck InjuriesSpinal Cord InjuriesHospital MortalityHumansMethylprednisoloneProspective StudiesRetrospective StudiesMethylprednisoloneCervical cordIn-hospital mortalitiesRegression analysisSpinal cord injuries

Identifiers

PMID37480505

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.