Low Nutrition before Injury Is a Risk Factor for Dysphagia in Older Patients with Cervical Spinal Cord Injury: Based on a Multicenter Data of 707 Patients

Spine Surg Relat Res, 2024 · DOI: 10.22603/ssrr.2023-0227 · Published: April 3, 2024

Simple Explanation

This study investigates risk factors for swallowing difficulties (dysphagia) in older adults who have suffered a spinal cord injury in the neck. Identifying these risks can help improve care and quality of life. The study found that poor nutrition before the injury, specifically a low Geriatric Nutritional Risk Index (GNRI), increases the risk of dysphagia after a cervical spinal cord injury in older adults. Besides nutrition, other risk factors include being male, having dementia, experiencing a fracture, complete paralysis, undergoing anterior surgery, and needing a tracheostomy.

Study Duration

2010 and 2020

Participants

707 patients with cervical SCI (mean age 75.3 years)

Evidence Level

Not specified

Key Findings

1
Low GNRI before injury was identified as an independent risk factor for dysphagia development in older adults with cervical SCI.
2
Male sex, dementia, fracture, complete paralysis, anterior surgery, and tracheostomy were also identified as significant risk factors for dysphagia.
3
Age, in this older patient cohort (mean age 75.3 years), was not found to be a significant risk factor for dysphagia.

Research Summary

This multicenter study analyzed data from 707 elderly patients with cervical SCI to identify risk factors for dysphagia. The study found that low GNRI before injury is an independent risk factor for dysphagia after geriatric cervical SCI. Significant risk factors identified include male sex, low GNRI, dementia, fracture, complete paralysis, anterior surgery and tracheostomy. Age was not identified as a risk factor in this elderly population. The study emphasizes the importance of assessing nutritional status using GNRI in elderly patients with cervical SCI to predict and manage the risk of dysphagia.

Practical Implications

Nutritional Assessment

Assess GNRI in elderly cervical SCI patients to identify those at higher risk of dysphagia.

Targeted Interventions

Implement proactive nutritional support and dysphagia management strategies for patients with low GNRI.

Surgical Planning

Consider the increased dysphagia risk associated with anterior surgery when planning surgical interventions in this population.

Study Limitations

1
Potential underestimation of dysphagia incidence due to retrospective data collection.
2
Inconsistent criteria for assessing dysphagia across different medical records.
3
Unclear long-term prognosis of dysphagia due to patient dropout.

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