The shoulder abductor strength is a novel predictor of tracheostomy in patients with traumatic cervical spinal cord injury

BMC Musculoskeletal Disorders, 2022 · DOI: https://doi.org/10.1186/s12891-022-05988-1 · Published: November 15, 2022

Spinal Cord Injury Surgery Musculoskeletal Medicine

Simple Explanation

This study investigates the relationship between shoulder abductor strength (SAS) and the need for tracheostomy in patients with traumatic cervical spinal cord injury (TCSCI). Early prediction of tracheostomy can help improve patient outcomes and allocate resources effectively. The researchers analyzed data from 513 TCSCI patients and found that weaker shoulder abductor strength (SAS grade 0–2) was significantly associated with a higher likelihood of requiring a tracheostomy. This suggests that SAS could be a useful predictor. A nomogram was created to visually represent the predictive ability of SAS, and it showed that SAS grade 0–2 had a considerable influence on the risk of tracheostomy. This finding indicates that assessing SAS could aid clinicians in making decisions about tracheostomy.

Study Duration

October 2010 to October 2020

Participants

513 TCSCI patients

Evidence Level

Not specified

Key Findings

1
Patients with SAS grade 0–2 had a significantly higher proportion in the tracheostomy group compared to the non-tracheostomy group (88.1% vs. 54.8%, p = 0.001).
2
SAS grade 0–2 was identified as a significant predictor of tracheostomy (OR: 4.505; 95% CI: 2.080–9.758; p = 0.001).
3
The area under the curve for the SAS grade 0–2 was 0.692, with a specificity of 0.951, indicating a good predictive ability for tracheostomy.

Research Summary

This study aimed to determine if shoulder abductor strength (SAS) is a predictor of tracheostomy in patients with traumatic cervical spinal cord injury (TCSCI). The results showed that lower SAS grades (0–2) were significantly associated with a higher likelihood of tracheostomy. SAS grade 0–2 had a good predictive ability of tracheostomy. The study concludes that SAS is a novel and simple predictor that can assist clinicians in making decisions about tracheostomy at the bedside.

Practical Implications

Clinical Prediction

SAS grade can be used as a simple bedside indicator to predict the necessity of tracheostomy in TCSCI patients.

Improved Decision-Making

Clinicians can use SAS assessment to assist in making more informed decisions regarding tracheostomy, potentially leading to better patient outcomes.

Resource Allocation

Early prediction of tracheostomy needs can help in the efficient allocation of resources in the management of TCSCI patients.

Study Limitations

1
Retrospective study design
2
The relationship between shoulder abduction and respiratory muscles needs further neuro-physiological experiments
3
Single-center experience

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