Failure to administer methylprednisolone for acute traumatic spinal cord injury-a prospective audit of 100 patients from a regional spinal injuries unit.

Abstract

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. To determine the actual use and correct implementation of the NASCIS protocols in patients referred to a regional spinal injuries unit. Observational study on the timing and correct dosage of methylprednisolone. The admission Frankel grade, American Spinal Injury Association (ASIA) neurological classification were recorded prospectively. The 100 consecutive patients with complete or incomplete spinal cord injuries (Frankel grade A-D) were studied over a 2 years period. Correct administration of methylprednisolone according to the NASCIS protocols. 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. Evidence based medicine is not being practiced in the management of patients with acute spinal cord injury.