Plasma fibrinogen level is independent risk factor associated with the incidence of pulmonary infection in patients with spinal cord injury: a retrospective cohort study

BMC Pulmonary Medicine, 2024 · DOI: https://doi.org/10.1186/s12890-024-03332-y · Published: October 7, 2024

Simple Explanation

Patients with spinal cord injuries (SCI) faced a significantly increased risk of pulmonary infections (PI), a leading cause of morbidity and mortality in this population. This study aims to elucidate the connection between plasma fibrinogen level and PI incidence among SCI patients, with the goal of informing prevention strategies. This study substantiated the role of surgery, injury level and chest comorbidities as pivotal covariates in the relationship between fibrinogen level and the incidence of PI among SCI patients.

Study Duration

January 1, 2017, to December 31, 2021

Participants

491 SCI patients

Evidence Level

Retrospective cohort study

Key Findings

1
For every 1 g/L increase in fibrinogen level, the risk of developing PI increased by 18% (HR = 1.18, P = 0.011), and indicating a positive linear relationship between fibrinogen level and PI incidence.
2
Plasma fibrinogen level emerged as an independent predictor of PI risk in SCI patients, especially for AIS-B and C grades.
3
Significant differences were observed between the PI-positive and PI-negative groups across several parameters: age, fibrinogen level, D-dimer level, smoking history, UTI, DVT, anticoagulant therapy, mode of injury, AIS grades, level of injury and chest comorbidities

Research Summary

This study investigated the relationship between plasma fibrinogen levels and the incidence of pulmonary infection (PI) in patients with spinal cord injury (SCI). The study found that elevated plasma fibrinogen levels were independently associated with an increased risk of PI in SCI patients, particularly those with AIS-B and C grades. Proactive management of fibrinogen levels after admission could be crucial in reducing PI incidence in this vulnerable population.

Practical Implications

Clinical Monitoring

Regularly monitor plasma fibrinogen levels in SCI patients, especially those with AIS-B and C grades, to assess their risk of developing PI.

Preventative Strategies

Implement proactive management strategies to control fibrinogen levels in SCI patients post-admission to potentially reduce the incidence of PI.

Targeted Interventions

Develop targeted interventions, such as early mobilization or respiratory therapy, for patients with different levels of SCI based on their fibrinogen levels and other risk factors.

Study Limitations

1
The study's retrospective design limits the ability to establish causality between fibrinogen levels and PI incidence.
2
The small sample size may limit the generalizability of the findings to broader populations.
3
The lack of external validation raises concerns about the robustness and applicability of the findings in different settings and patient populations.

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