Prognostic Factors for Respiratory Dysfunction for Cervical Spinal Cord Injury and/or Cervical Fractures in Elderly Patients: A Multicenter Survey

Global Spine Journal, 2024 · DOI: 10.1177/21925682221095470 · Published: January 1, 2024

Simple Explanation

This study looks at respiratory problems in elderly patients who have hurt their spinal cords in their neck. It aims to find out what makes these problems more likely. The researchers looked at information from 1353 elderly patients in Japan who had spinal cord injuries. They checked things like age, health, and the type of injury to see what was linked to breathing issues. The study found that older patients, those with certain health conditions like OPLL, and those with severe paralysis were more likely to have respiratory problems after a spinal cord injury.

Study Duration

2010 to 2020

Participants

1353 elderly cervical SCI patients

Evidence Level

Retrospective Cohort Study

Key Findings

1
Age, lower albumin levels, high blood glucose, cervical OPLL, anterior vertebral hematoma, and severe neurological symptoms are independent risk factors for respiratory dysfunction.
2
Lower albumin levels and head injury were independent risk factors for long-term respiratory dysfunction.
3
In cervical SCI cases without cervical fracture, lower albumin and severe neurological symptoms were independent risk factors.

Research Summary

This study investigated the prognosis of respiratory function in elderly patients with cervical spinal cord injury (SCI) and to identify predictive factors. A total of 104 patients (7.8%) had impaired respiratory function. In multiple logistic regression analysis, age, blood glucose level, presence of ossiﬁcation of posterior longitudinal ligament (OPLL), anterior vertebral hematoma, and critical paralysis were selected as independent risk factors. Age, OPLL, severe paralysis, anterior vertebral hematoma, hypoalbuminemia, and blood glucose level at the time of injury were independent factors for respiratory failure. Hyperglycemia may have a negative effect on respiratory function in this condition.

Practical Implications

Risk Assessment

The identified risk factors can help clinicians to proactively identify elderly patients with cervical SCI who are at higher risk of developing respiratory dysfunction.

Targeted Interventions

Knowing the risk factors allows for targeted interventions such as glycemic control and nutritional support (albumin management) to potentially improve respiratory outcomes.

Surgical Timing

The study suggests a possible association between early surgery and respiratory failure, warranting careful consideration of surgical timing in these patients.

Study Limitations

1
Retrospective study design
2
Lack of clear criteria for tracheostomy eligibility
3
The study did not consider the patients’ original respiratory status and other details of their history

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