Identification of risk factors for respiratory complications in upper cervical spinal injured patients with neurological impairment.
Acta Orthop Traumatol Turc
; 47(2): 111-7, 2013.
Article
en En
| MEDLINE
| ID: mdl-23619544
ABSTRACT
OBJECTIVE:
Clinical features of respiratory complications in patients with upper cervical spine injuries (CSI) are unique due to the complex regional anatomy in the region. The objective of this study was to identify the risk factors for respiratory complications in the patients with upper CSI and cervical spinal cord injuries (C-SCI).METHODS:
Ninety-two patients (out of 1593 spine injured patients) who met the inclusion criteria of upper CSI were admitted to our hospital from 1992 to 2010. Their records were retrospectively reviewed.RESULTS:
Respiratory complications occurred in 16 patients (17.4%). In addition, ventilator-associated pneumonia played an important role in the respiratory complications, however, no pulmonary thromboembolism was found. Death rate in respiratory complication group (RCG, 31.3%) was significantly higher than that in non-respiratory complication group (NCG, 1.3%). In RCG, severe C-SCI (American Spinal Cord Injury Association Grades A and B, OR=34.401; 95% CI, 2.609-5.525) and hypoalbuminemia (OR=24.616; 95% CI, 1.492-6.182) were identified by logistic regression analysis as main risk factors for respiratory complications; whereas levels of neurological injury, quadriplegia, atlanto-axial fractures, smoking history, and electrolyte disturbances were not identified as risk factors (although statistically relevant to respiratory complications).CONCLUSION:
Severe C-SCI and hypoalbuminemia played important roles in predicting respiratory complications among the patients with upper CSI and neurological impairment. In addition, levels of neurological injury, quadriplegia, atlanto-axial fractures, smoking history, and electrolyte disturbances are also valuable indicators for these complications. Moreover, prevention of ventilator-associated pneumonia was crucial in the treatment of these patients. However, a screening for deep venous thrombosis was seemingly unnecessary in our patients.
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Colección:
01-internacional
Base de datos:
MEDLINE
Contexto en salud:
1_ASSA2030
/
2_ODS3
/
4_TD
/
6_ODS3_enfermedades_notrasmisibles
Problema de salud:
1_doencas_nao_transmissiveis
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2_muertes_prematuras_enfermedades_notrasmisibles
/
4_pneumonia
/
6_other_respiratory_diseases
/
6_venous_thromboembolic_disease
Asunto principal:
Insuficiencia Respiratoria
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Traumatismos Vertebrales
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Vértebras Cervicales
Tipo de estudio:
Diagnostic_studies
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Etiology_studies
/
Observational_studies
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Prognostic_studies
/
Risk_factors_studies
Límite:
Adult
/
Humans
/
Middle aged
Idioma:
En
Revista:
Acta Orthop Traumatol Turc
Asunto de la revista:
ORTOPEDIA
/
TRAUMATOLOGIA
Año:
2013
Tipo del documento:
Article
País de afiliación:
China