Vital sign differences between septic patients with tetraplegia and paraplegia

Spinal Cord Series and Cases, 2022 · DOI: https://doi.org/10.1038/s41394-022-00553-3 · Published: December 1, 2022

Spinal Cord Injury Critical Care Physiology

Simple Explanation

The study investigates differences in vital signs and mental status between septic patients with tetraplegia and paraplegia. Patients with tetraplegia may not be able to mount fever and tachycardia to the same degree as patients with paraplegia. The findings suggest changes to vital signs parameter cut-offs may improve sensitivity and be useful in identifying sepsis earlier in the tetraplegic population.

Study Duration

June 1, 2010 and June 1, 2018

Participants

19 patients with tetraplegia and 16 with paraplegia

Evidence Level

Retrospective chart review

Key Findings

1
Septic patients with tetraplegia had lower maximum temperature compared to septic patients with paraplegia.
2
Septic patients with tetraplegia had lower maximum heart rate compared to septic patients with paraplegia.
3
Septic patients with tetraplegia had more frequent altered mental status compared to septic patients with paraplegia.

Research Summary

This study examines the differences in vital signs and mental status between septic patients with tetraplegia and paraplegia to improve early identification of sepsis in the tetraplegic population. The study found that patients with tetraplegia may not be able to mount fever and tachycardia to the same degree as patients with paraplegia. The findings suggest that changes to vital sign parameter cut-offs may improve sensitivity and be useful in identifying sepsis earlier in the tetraplegic population.

Practical Implications

Sepsis Screening Tools

Recognition that patients with tetraplegia may not mount fever or tachycardia to the same degree as patients with paraplegia has important implications regarding sepsis screening. Current sepsis screening tools may need to be adjusted for the SCI population.

SAE Interventions

Septic patients with tetraplegia may be more likely to experience AMS compared to patients with paraplegia, suggesting that this population may benefit from interventions aimed specifically at SAE.

Vital Sign Parameter Cut-Offs

Changes to vital signs parameter cut-offs may improve sensitivity and be useful in identifying sepsis earlier in the tetraplegic population.

Study Limitations

1
Small sample size
2
All study participants were male, limiting the generalizability of the results.
3
Analysis of respiratory rate was excluded due to accuracy concerns.

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