Airway complications in traumatic lower cervical spinal cord injury: A retrospective study.
J Spinal Cord Med
; 38(5): 607-14, 2015 Sep.
Article
em En
| MEDLINE
| ID: mdl-25117865
ABSTRACT
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.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Pneumonia
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Insuficiência Respiratória
/
Traumatismos da Medula Espinal
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Manuseio das Vias Aéreas
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Medula Cervical
Tipo de estudo:
Observational_studies
/
Prognostic_studies
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Risk_factors_studies
Limite:
Adolescent
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Adult
/
Aged
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Aged80
/
Female
/
Humans
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Male
/
Middle aged
Idioma:
En
Revista:
J Spinal Cord Med
Assunto da revista:
NEUROLOGIA
/
REABILITACAO
Ano de publicação:
2015
Tipo de documento:
Article