Incidence and Risk Factors for Pneumonia in the Chronic Phase of Cervical Spinal Cord Injury with Complete Motor Paralysis

Spine Surg Relat Res, 2023 · DOI: 10.22603/ssrr.2022-0254 · Published: January 17, 2023

Spinal Cord Injury Immunology Rehabilitation

Simple Explanation

This study investigates pneumonia in patients with cervical spinal cord injury (CSCI) who have complete motor paralysis. It aims to find out how often pneumonia occurs in the long term and what factors increase the risk. The study suggests that managing atelectasis, respiratory muscle rehabilitation, and improving swallowing are important for preventing pneumonia recurrence.

Study Duration

90 days minimum

Participants

69 patients with CSCI with American Spinal Injury Association Impairment Scale grades of A or B

Evidence Level

Retrospective clinical observational study

Key Findings

1
Pneumonia occurred in 36% of patients throughout the study period and in 20% after 30 days of hospitalization.
2
Atelectasis, enteral feeding, mechanical ventilation, and tracheotomy within 30 days of admission were significantly associated with pneumonia after 30 days.
3
Patients with any of these risk factors (enteral feeding, mechanical ventilation, or tracheotomy) had a higher recurrence rate of pneumonia.

Research Summary

This retrospective study examined the incidence and risk factors for pneumonia in patients with cervical spinal cord injury (CSCI) and complete motor paralysis. The study found that pneumonia occurred in 36% of patients overall, with 20% developing it after 30 days of hospitalization. Key risk factors for pneumonia in the chronic phase included atelectasis, enteral feeding, mechanical ventilation, and tracheotomy within the first 30 days of hospitalization.

Practical Implications

Early Intervention

Address atelectasis promptly with airway clearance, breathing exercises, and early mobilization.

Rehabilitation Focus

Emphasize long-term respiratory muscle rehabilitation and swallowing function improvement training.

Risk Factor Management

Prioritize pneumonia prevention during enteral feeding, mechanical ventilation, and tracheostomy.

Study Limitations

1
Small sample size may have led to chance errors.
2
Follow-up period of >90 days may not be sufficient to accurately assess chronic pneumonia rate.
3
The extent to which pneumonia developed in patients discharged under 90 days was unknown.

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