10-11-2002, 06:06 AM
• Molloy S, Middleton F and Casey A (2002). Failure to administer methylprednisolone for acute traumatic spinal cord injury-a prospective audit of 100 patients from a regional spinal injuries unit. Injury. 33 (7): 575. Summary: OVERVIEW: The National Acute Spinal Cord Injury Studies (NASCIS II and III) and the Cochrane review advocate the administration of high dose methylprednisolone following acute traumatic spinal cord injury.OBJECTIVE: To determine the actual use and correct implementation of the NASCIS protocols in patients referred to a regional spinal injuries unit.DESIGN: Observational study on the timing and correct dosage of methylprednisolone. The admission Frankel grade, American Spinal Injury Association (ASIA) neurological classification were recorded prospectively.SUBJECTS: The 100 consecutive patients with complete or incomplete spinal cord injuries (Frankel grade A-D) were studied over a 2 years period.MAIN OUTCOME MEASURE: Correct administration of methylprednisolone according to the NASCIS protocols.RESULTS: During the study period only 25% of the patients admitted to our spinal injuries unit received methylprednisolone at the referring hospital according to the NASCIS protocols. An additional 10 patients were given methylprednisolone incorrectly.CONCLUSION: Evidence based medicine is not being practiced in the management of patients with acute spinal cord injury. Specialist Registrar, Trauma and Orthopaedics, South West Thames, UK.