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

Abstract

Study design Retrospective Cohort Study Objective The purpose of this study was to investigate the prognosis of respiratory function in elderly patients with cervical spinal cord injury (SCI) and to identify predictive factors. Methods We included 1353 cases of elderly cervical SCI patients collected from 78 institutions in Japan. Patients who required early tracheostomy and ventilator management and those who developed respiratory complications were defined as the respiratory disability group. Patients’ background characteristics, injury mechanism, injury form, neurological disability, complications, and treatment methods were compared between the disability and non-disability groups. Multiple logistic regression analysis was used to examine the independent factors. Patients who required respiratory management for 6 months or longer after injury and those who died of respiratory complications were classified into the severe disability group and were compared with minor cases who were weaned off the respirator. Results A total of 104 patients (7.8%) had impaired respiratory function. Comparisons between the disabled and non-disabled groups and between the severe and mild injury groups yielded distinct trends. 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. Conclusion 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.

Deep Learning-Based Prediction Model for Gait Recovery after a Spinal Cord Injury

“…The accurate prediction of prognosis for a certain disease or trauma has been one of the main goals of rehabilitation medicine. For this reason, many studies have been conducted to evaluate prognostic factors of various functional outcomes such as AIS, Barthel Index, Spinal Cord Independence Measure, and respiratory dysfunction [ 20 , 21 , 22 ]. However, there has been a lack of research on developing prediction models that integrate such predictors.…”

Impact of malnutrition on mortality and neurological recovery of older patients with spinal cord injury

“…This study retrospectively analyzed multicenter registry data collected by the Japan Association of Spine Surgeons with Ambition (JASA) 20 – 22 . All study participants provided written informed consent.…”

“…The JASA members, who are spine surgeons from 78 institutions in Japan, reviewed the medical records of their institutions and retrospectively registered the cases in the JASA database based on the following inclusion and exclusion criteria 20 – 22 . The following patients were included those aged ≥ 65 years with traumatic cervical SCI, those treated conservatively or surgically between 2010 and 2020 at one’s institution, and those followed up for at least 3 months post-injury.…”

Cervical Fracture with Diffuse Idiopathic Skeletal Hyperostosis and Respiratory Insufficiency: A Case Report

“…There are several reports in the literature of arterial injury due to cervical spinal injury, which is a life-threatening condition (Table 1) 5,6) . A recent systematic review showed that the majority of the traumatic retropharyngeal hematoma with respiratory symptoms was in geriatric patients with falls or traffic accidents whose symptoms developed within 24 h of blunt trauma, and surgical treatment was performed in 23% of patients 7) .…”