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

被引：13

作者：

Hirota, Ryosuke ^{[1
]}

Terashima, Yoshinori ^{[1
,2
]}

Ohnishi, Hirofumi ^{[3
]}

Yamashita, Toshihiko ^{[1
]}

Yokogawa, Noriaki ^{[4
]}

Sasagawa, Takeshi ^{[4
,5
]}

Ando, Kei ^{[6
]}

Nakashima, Hiroaki ^{[6
]}

Segi, Naoki ^{[6
]}

Funayama, Toru ^{[7
]}

Eto, Fumihiko ^{[8
]}

Yamaji, Akihiro ^{[9
]}

Watanabe, Kota ^{[10
]}

Yamane, Junichi ^{[10
,11
]}

Takeda, Kazuki ^{[10
,12
]}

Furuya, Takeo ^{[13
]}

Yunde, Atsushi ^{[13
]}

Nakajima, Hideaki ^{[14
]}

Yamada, Tomohiro ^{[15
,16
]}

Hasegawa, Tomohiko ^{[15
]}

Suzuki, Hidenori ^{[17
]}

Imajo, Yasuaki ^{[17
]}

Ikegami, Shota ^{[18
]}

Uehara, Masashi ^{[18
]}

Tonomura, Hitoshi ^{[19
]}

Sakata, Munehiro ^{[19
,20
]}

Hashimoto, Ko ^{[21
]}

Onoda, Yoshito ^{[21
]}

Kawaguchi, Kenichi ^{[22
]}

Haruta, Yohei ^{[22
]}

Suzuki, Nobuyuki ^{[23
]}

Kato, Kenji ^{[23
]}

Uei, Hiroshi ^{[24
,25
]}

Sawada, Hirokatsu ^{[25
]}

Nakanishi, Kazuo ^{[26
]}

Misaki, Kosuke ^{[26
]}

Terai, Hidetomi ^{[27
]}

Tamai, Koji ^{[27
]}

Shirasawa, Eiki ^{[28
]}

Inoue, Gen ^{[28
]}

Kakutani, Kenichiro ^{[29
]}

Kakiuchi, Yuji ^{[29
]}

Kiyasu, Katsuhito ^{[30
]}

Tominaga, Hiroyuki ^{[31
]}

Tokumoto, Hiroto ^{[31
]}

Iizuka, Yoichi ^{[32
]}

Takasawa, Eiji ^{[32
]}

Akeda, Koji ^{[33
]}

Takegami, Norihiko ^{[33
]}

Funao, Haruki ^{[34
,35
,36
,37
]}

机构：

[1] Sapporo Med Univ, Dept Orthopaed Surg, Sapporo, Hokkaido, Japan

[2] Matsuda Orthoped Mem Hosp, Dept Orthopaed Surg, Sapporo, Hokkaido, Japan

[3] Sapporo Med Univ, Dept Publ Hlth, Sapporo, Hokkaido, Japan

[4] Kanazawa Univ, Grad Sch Med Sci, Dept Orthopaed Surg, Kanazawa, Ishikawa, Japan

[5] Toyama Prefectural Cent Hosp, Dept Orthoped Surg, Toyama, Japan

[6] Nagoya Univ, Grad Sch Med, Dept Orthoped Surg, Nagoya, Aichi, Japan

[7] Univ Tsukuba, Fac Med, Dept Orthopaed Surg, Tsukuba, Ibaraki, Japan

[8] Univ Tsukuba, Grad Sch Comprehens Human Sci, Dept Orthopaed Surg, Tsukuba, Ibaraki, Japan

[9] Ibaraki Seinan Med Ctr Hosp, Dept Orthopaed Surg, Ibaraki, Japan

[10] Keio Univ, Dept Orthopaed Surg, Sch Med, Shinjuku Ku, Tokyo, Japan

[11] Natl Hosp Org Murayama Med Ctr, Dept Orthopaed Surg, Musashimurayama, Japan

[12] Japanese Red Cross Shizuoka Hosp, Dept Orthopaed Surg, Shizuoka, Japan

[13] Chiba Univ, Grad Sch Med, Dept Orthopaed Surg, Chiba, Japan

[14] Univ Fukui, Dept Orthopaed & Rehabil Med, Fac Med Sci, Fukui, Japan

[15] Hamamatsu Univ Sch Med, Dept Orthopaed Surg, Hamamatsu, Shizuoka, Japan

[16] Nagoya Kyoritsu Hosp, Dept Orthopaed Surg, Nagoya, Aichi, Japan

[17] Yamaguchi Univ, Dept Orthopaed Surg, Grad Sch Med, Ube, Yamaguchi, Japan

[18] Shinshu Univ, Dept Orthopaed Surg, Sch Med, Matsumoto, Nagano, Japan

[19] Kyoto Prefectural Univ Med, Grad Sch Med Sci, Dept Orthopaed, Kyoto, Japan

[20] Saiseikai Shiga Hosp, Dept Orthopaed, Ritto, Shiga, Japan

[21] Tohoku Univ, Dept Orthoped Surg, Grad Sch Med, Sendai, Miyagi, Japan

[22] Kyushu Univ, Grad Sch Med Sci, Dept Orthoped Surg, Fukuoka, Japan

[23] Nagoya City Univ, Dept Orthoped Surg, Grad Sch Med Sci, Nagoya, Aichi, Japan

[24] Nihon Univ Hosp, Dept Orthoped Surg, Chiyoda Ku, Tokyo, Japan

[25] Nihon Univ, Dept Orthoped Surg, Sch Med, Itabashi Ku, Tokyo, Japan

[26] Kawasaki Med Sch, Dept Orthoped Traumatol & Spine Surg, Kurashiki, Okayama, Japan

[27] Osaka City Univ, Dept Orthoped Surg, Grad Sch Med, Osaka, Japan

[28] Kitasato Univ, Dept Orthopaed Surg, Sch Med, Sagamihara, Kanagawa, Japan

[29] Kobe Univ, Dept Orthopaed Surg, Grad Sch Med, Kobe, Hyogo, Japan

[30] Kochi Univ, Kochi Med Sch, Dept Orthopaed Surg, Nankoku, Kochi, Japan

[31] Kagoshima Univ, Grad Sch Med & Dent Sci, Dept Orthopaed Surg, Kagoshima, Japan

[32] Gunma Univ, Grad Sch Med, Dept Orthopaed Surg, Maebashi, Gumma, Japan

[33] Mie Univ, Dept Orthopaed Surg, Grad Sch Med, Tsu, Mie, Japan

[34] Int Univ Hlth & Welf, Sch Med, Dept Orthopaed Surg, Narita, Japan

[35] Int Univ Hlth & Welf Narita Hosp, Dept Orthopaed Surg, Narita, Japan

[36] Int Univ Hlth & Welf Mita Hosp, Dept Orthopaed Surg, Minato Ku, Tokyo, Japan

[37] Int Univ Hlth & Welf Mita Hosp, Spine & Spinal Cord Ctr, Minato Ku, Tokyo, Japan

[38] Univ Tokyo Hosp, Dept Orthopaed Surg, Bunkyo Ku, Tokyo, Japan

[39] Osaka Univ, Dept Orthopaed Surg, Grad Sch Med, Suita, Osaka, Japan

[40] Tokai Univ, Dept Orthoped Surg, Surg Sci, Sch Med, Isehara, Kanagawa, Japan

[41] Tokyo Med & Dent Univ, Dept Orthopaed Surg, Bunkyo Ku, Tokyo, Japan

[42] Univ Yamanashi, Dept Orthopaed Surg, Chuo Ku, Kofu, Yamanashi, Japan

[43] Kyoto Univ, Grad Sch Med, Dept Orthopaed Surg, Kyoto, Japan

[44] Univ Toyama, Fac Med, Dept Orthopaed Surg, Toyama, Japan

[45] Oita Univ, Fac Med, Dept Orthopaed Surg, Oita, Japan

[46] Kansai Med Univ Hosp, Dept Orthopaed Surg, Hirakata, Osaka, Japan

来源：

GLOBAL SPINE JOURNAL | 2024年 / 14卷 / 01期

关键词：

cervical spinal cord injury; respiratory dysfunction; risk factor; hyperglycemia; RISK-FACTORS; TRACHEOSTOMY; CLASSIFICATION;

D O I：

10.1177/21925682221095470

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

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.

引用

页码：101 / 112

页数：12

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