The Mortality Inflection Point for Age and Acute Cervical Spinal Cord Injury

Martin, Niels D.; Marks, Joshua A.; Donohue, Joshua; Giordano, Carolyn; Cohen, Murray; Weinstein, Michael

doi:10.1097/ta.0b013e318228221f

Cited by 29 publications

(40 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…table). Among studies with a cervical TSCI-only population in-hospital mortality varied between 4.2 and 26.2% [49,56,66,94,105]. Study estimates for one geriatric population was 23.1% (online suppl.…”

Section: Resultsmentioning

confidence: 99%

“…More than one third of all included studies were from the United States (n = 28) [18,36,37,38,39,40,41,42,43,44,45,46,47,48,49,50,51,52,53,54,55,56,57,58,59,60,61,62]; roughly 13% of studies were conducted in Canada (n = 10) [17,63,64,65,66,67,68,69,70,71], 5% in Israel (n = 4) [72,73,74,75], 5% in Australia (n = 4) [9,76,77,78]; 4% in France (n = 3) [79,80,81]; 4% from Norway (n = 3) [7,10,19]; while the remaining were from countries including Brazil, China, Estonia, Finland, Greece, Germany, Iceland, Italy, Japan, the Netherlands, Nigeria, Poland, Scotland, Sierra Leone, South Africa, Sweden, Taiwan, and the United Kingdom (see online suppl. table; for all online suppl.…”

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Mortality and Longevity after a Spinal Cord Injury: Systematic Review and Meta-Analysis

Chamberlain

Meier²,

Mader³

et al. 2015

Neuroepidemiology

135

101

View full text Add to dashboard Cite

Background/Aims: Mortality and longevity studies of spinal cord injury (SCI) are essential for informing healthcare systems and policies. This review evaluates the current evidence among people with SCIs worldwide in relation to the WHO region and country income level; demographic and lesion characteristics; and in comparison with the general population. Methods: A systematic review of relevant databases for original studies. Pooled estimates were derived using random effects meta-analysis, restricted to traumatic SCI. Results: Seventy-four studies were included. In-hospital mortality varied, with pooled estimates of 24.1% (95% confidence interval (CI) 14.1-38.0), 7.6% (95% CI 6.3-9.0), 7.0% (95% CI 1.5-27.4), and 2.1% (95% CI 0.9-5.0) in the WHO regions of Africa, the Americas, Europe and Western Pacific. The combined estimate for low- and middle-income countries was nearly three times higher than for high-income countries. Pooled estimates of first-year survival were 86.5% (95% CI 75.3-93.1), 95.6% (95% CI 81.0-99.1), and 94.0% (95% CI 93.3-94.6) in the Americas, Europe and Western Pacific. Pooled estimates of standardized mortality ratios in tetraplegics were 2.53 (2.00-3.21) and 2.07 (1.47-2.92) in paraplegics. Conclusion: This study found substantial variation in mortality and longevity within the SCI population, compared to the general population, and between WHO regions and country income level. Improved standardization and quality of reporting is needed to improve inferences regarding the extent to which mortality outcomes following an SCI are related to healthcare systems, services and policies.

show abstract

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Mortality and Longevity after a Spinal Cord Injury: Systematic Review and Meta-Analysis

Chamberlain

Meier²,

Mader³

et al. 2015

Neuroepidemiology

135

101

View full text Add to dashboard Cite

show abstract

“…17 Overall, the incidence of respiratory complications in the acute phase is up to 80%. 2,5,6,17,19,20 The rate of respiratory complications varies with the degree of motor deterioration 1,16,19,21,22 and the anatomical and neurological level of SCI. 1,2,19 The mortality rate is up to 3.5% and increases with age 1,5,21,22 and pre-existing morbidity.…”

Section: Introductionmentioning

confidence: 99%

“…Patients with cervical spinal cord injury (cSCI) are differentiated into high and low cervical level 1,2 and into motor complete and incomplete SCI 1 because these factors determine the rate of respiratory failure and respiratory complications. In this work, we focused on patients with lower cSCI (lcSCI) defined as lesions at levels C4-C8, and with complete motor SCI, corresponding to the American Spinal Injury Association (ASIA) Impairment Scale (AIS) A or B.…”

Section: Introductionmentioning

confidence: 99%

Airway complications in traumatic lower cervical spinal cord injury: A retrospective study

Liebscher¹,

Niedeggen²,

Estel³

et al. 2014

The Journal of Spinal Cord Medicine

View full text Add to dashboard Cite

Objective: To investigate risk factors for pneumonia in patients with traumatic lower cervical spinal cord injury. Design: Observational study, retrospective study. Setting: Spinal cord unit in a maximum care hospital. Methods: Thirty-seven patients with acute isolated traumatic spinal cord injury at levels C4-C8 and complete motor function injury (AIS A, B) treated from 2004 to 2010 met the criteria for inclusion in our retrospective analysis. The following parameters were considered: ventilation-specific parameters, re-intubation, creation of a tracheostomy, pneumonia, antibiotic treatment, and length of intensive care unit (ICU) stay and total hospitalization. Results: Among the patients, 81% had primary invasive ventilation. In 78% of cases a tracheostomy was created; 3% of these cases were discharged with invasive ventilation and 28% with a tracheostomy without ventilation. Pneumonia according to Centers for Disease Control criteria occurred in 51% of cases within 21 ± 32 days of injury, and in 3% at a later date. The number of pre-existing conditions was significantly associated with pneumonia. Length of ICU stay was 25 ± 34 days, and average total hospital duration was 230 ± 144 days. Significant factors affecting the duration of ventilation were the number of pre-existing conditions and tetraplegia-specific complications. Conclusions: Our results confirm that patients with traumatic lower cervical spinal cord injuries defined by lesion level and AIS constitute a homogeneous group. This group is characterized by a high rate of pneumonia during the first 4 weeks after injury. The number of pre-existing general conditions and spinal injury-specific comorbidities are the only risk factors identified for the development of pneumonia and/or duration of ventilation.

show abstract

“…The extent of this reduction in respiratory function depends on the neurological level and the extent of motor function loss. 2,7 more effective coughing to assist removal of secretions and a reduction in secretion resulting from autonomic dysfunction. 8 There are many existing therapies for improving respiratory function in patients with tetraplegia.…”

Section: Introductionmentioning

confidence: 99%

Breathing-synchronised electrical stimulation of the abdominal muscles in patients with acute tetraplegia: A prospective proof-of-concept study

Liebscher

Schauer

Stephan

et al. 2016

The Journal of Spinal Cord Medicine

View full text Add to dashboard Cite

show abstract

The Mortality Inflection Point for Age and Acute Cervical Spinal Cord Injury

Cited by 29 publications

References 15 publications

Mortality and Longevity after a Spinal Cord Injury: Systematic Review and Meta-Analysis

Mortality and Longevity after a Spinal Cord Injury: Systematic Review and Meta-Analysis

Airway complications in traumatic lower cervical spinal cord injury: A retrospective study

Breathing-synchronised electrical stimulation of the abdominal muscles in patients with acute tetraplegia: A prospective proof-of-concept study

Contact Info

Product

Resources

About