. 2024 Jan;14(1):101-112.

doi: 10.1177/21925682221095470. Epub 2022 May 26.

Prognostic Factors for Respiratory Dysfunction for Cervical Spinal Cord Injury and/or Cervical Fractures in Elderly Patients: A Multicenter Survey

Ryosuke Hirota¹, Yoshinori Terashima^{1

2}, Hirofumi Ohnishi³, Toshihiko Yamashita¹, Noriaki Yokogawa⁴, Takeshi Sasagawa^{4

5}, Kei Ando⁶, Hiroaki Nakashima⁶, Naoki Segi⁶, Toru Funayama⁷, Fumihiko Eto⁸, Akihiro Yamaji⁹, Kota Watanabe¹⁰, Junichi Yamane^{10

11}, Kazuki Takeda^{10

12}, Takeo Furuya¹³, Atsushi Yunde¹³, Hideaki Nakajima¹⁴, Tomohiro Yamada^{15

16}, Tomohiko Hasegawa¹⁵, Hidenori Suzuki¹⁷, Yasuaki Imajo¹⁷, Shota Ikegami¹⁸, Masashi Uehara¹⁸, Hitoshi Tonomura¹⁹, Munehiro Sakata^{19

20}, Ko Hashimoto²¹, Yoshito Onoda²¹, Kenichi Kawaguchi²², Yohei Haruta²², Nobuyuki Suzuki²³, Kenji Kato²³, Hiroshi Uei^{24

25}, Hirokatsu Sawada²⁵, Kazuo Nakanishi²⁶, Kosuke Misaki²⁶, Hidetomi Terai²⁷, Koji Tamai²⁷, Eiki Shirasawa²⁸, Gen Inoue²⁸, Kenichiro Kakutani²⁹, Yuji Kakiuchi²⁹, Katsuhito Kiyasu³⁰, Hiroyuki Tominaga³¹, Hiroto Tokumoto³¹, Yoichi Iizuka³², Eiji Takasawa³², Koji Akeda³³, Norihiko Takegami³³, Haruki Funao^{34

35

36}, Yasushi Oshima³⁷, Takashi Kaito³⁸, Daisuke Sakai³⁹, Toshitaka Yoshii⁴⁰, Tetsuro Ohba⁴¹, Bungo Otsuki⁴², Shoji Seki⁴³, Masashi Miyazaki⁴⁴, Masayuki Ishihara⁴⁵, Seiji Okada³⁸, Shiro Imagama⁶, Satoshi Kato⁴

Affiliations

¹ Department of Orthopaedic Surgery, Sapporo Medical University, Sapporo, Japan.
² Department of Orthopaedic Surgery, Matsuda Orthopedic Memorial Hospital, Sapporo, Japan.
³ Department of Public Health, Sapporo Medical University, Sapporo, Japan.
⁴ Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa University, Kanazawa, Japan.
⁵ Department of Orthopedics Surgery, Toyama Prefectural Central Hospital, Toyama, Japan.
⁶ Department of Orthopedic Surgery, Graduate School of Medicine, Nagoya University, Nagoya, Japan.
⁷ Department of Orthopaedic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan.
⁸ Department of Orthopaedic Surgery, Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Japan.
⁹ Department of Orthopaedic Surgery, Ibaraki Seinan Medical Center Hospital, Ibaraki, Japan.
¹⁰ Department of Orthopaedic Surgery, Keio University School of Medicine, Shinjuku-ku, Japan.
¹¹ Department of Orthopaedic Surgery, National Hospital Organization Murayama Medical Center, Musashimurayama, Japan.
¹² Department of Orthopaedic Surgery, Japanese Red Cross Shizuoka Hospital, Shizuoka, Japan.
¹³ Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan.
¹⁴ Department of Orthopaedics and Rehabilitation Medicine, Faculty of Medical Sciences University of Fukui, Yoshida-gun, Japan.
¹⁵ Department of Orthopaedic Surgery, Hamamatsu University School of Medicine, Hamamatsu City, Japan.
¹⁶ Department of Orthopaedic Surgery, Nagoya Kyoritsu Hospital, Nagoya-shi, Japan.
¹⁷ Department of Orthopaedic Surgery, Yamaguchi University Graduate School of Medicine, Ube City, Japan.
¹⁸ Department of Orthopaedic Surgery, Shinshu University School of Medicine, Matsumoto, Japan.
¹⁹ Department of Orthopaedics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan.
²⁰ Department of Orthopaedics, Saiseikai Shiga Hospital, Shiga, Japan.
²¹ Department of Orthopedic Surgery, Tohoku University Graduate School of Medicine, Sendai, Japan.
²² Department of Orthopedic Surgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
²³ Department of Orthopedic Surgery, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan.
²⁴ Department of Orthopedic Surgery, Nihon University Hospital, Chiyoda-ku, Japan.
²⁵ Department of Orthopedic Surgery, Nihon University School of Medicine, Itabashi-ku, Japan.
²⁶ Department of Orthopedics, Traumatology and Spine Surgery, Kawasaki Medical School, Kurashiki, Japan.
²⁷ Department of Orthopedic Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan.
²⁸ Department of Orthopaedic Surgery, Kitasato University School of Medicine, Sagamihara, Japan.
²⁹ Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.
³⁰ Department of Orthopaedic Surgery, Kochi Medical School, Kochi University, Nankoku, Japan.
³¹ Department of Orthopaedic Surgery, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan.
³² Department of Orthopaedic Surgery, Graduate School of Medicine, Gunma University, Maebashi, Japan.
³³ Department of Orthopaedic Surgery, Mie University Graduate School of Medicine, Tsu City, Japan.
³⁴ Department of Orthopaedic Surgery, School of Medicine, International University of Health and Welfare, Narita, Japan.
³⁵ Department of Orthopaedic Surgery, International University of Health and Welfare Narita Hospital, Narita, Japan.
³⁶ Department of Orthopaedic Surgery and Spine and Spinal Cord Center, International University of Health and Welfare Mita Hospital, Minato-ku, Japan.
³⁷ Department of Orthopaedic Surgery, The University of Tokyo Hospital, Bunkyo-ku, Japan.
³⁸ Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, Suita, Japan.
³⁹ Department of Orthopedics Surgery, Surgical Science, Tokai University School of Medicine, Isehara, Japan.
⁴⁰ Department of Orthopaedic Surgery, Tokyo Medical and Dental University, Bunkyo-Ku, Japan.
⁴¹ Department of Orthopaedic Surgery, University of Yamanashi, Chuo, Japan.
⁴² Department of Orthopaedic Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
⁴³ Department of Orthopaedic Surgery, Faculty of Medicine, University of Toyama, Toyama, Japan.
⁴⁴ Department of Orthopaedic Surgery, Faculty of Medicine, Oita University, Oita, Japan.
⁴⁵ Department of Orthopaedic Surgery, Kansai Medical University Hospital, Hirakata, Osaka, Japan.

PMID: 35617466
PMCID: PMC10676156
DOI: 10.1177/21925682221095470

Prognostic Factors for Respiratory Dysfunction for Cervical Spinal Cord Injury and/or Cervical Fractures in Elderly Patients: A Multicenter Survey

Ryosuke Hirota et al. Global Spine J. 2024 Jan.

. 2024 Jan;14(1):101-112.

doi: 10.1177/21925682221095470. Epub 2022 May 26.

Authors

Affiliations

¹ Department of Orthopaedic Surgery, Sapporo Medical University, Sapporo, Japan.
² Department of Orthopaedic Surgery, Matsuda Orthopedic Memorial Hospital, Sapporo, Japan.
³ Department of Public Health, Sapporo Medical University, Sapporo, Japan.
⁴ Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa University, Kanazawa, Japan.
⁵ Department of Orthopedics Surgery, Toyama Prefectural Central Hospital, Toyama, Japan.
⁶ Department of Orthopedic Surgery, Graduate School of Medicine, Nagoya University, Nagoya, Japan.
⁷ Department of Orthopaedic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan.
⁸ Department of Orthopaedic Surgery, Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Japan.
⁹ Department of Orthopaedic Surgery, Ibaraki Seinan Medical Center Hospital, Ibaraki, Japan.
¹⁰ Department of Orthopaedic Surgery, Keio University School of Medicine, Shinjuku-ku, Japan.
¹¹ Department of Orthopaedic Surgery, National Hospital Organization Murayama Medical Center, Musashimurayama, Japan.
¹² Department of Orthopaedic Surgery, Japanese Red Cross Shizuoka Hospital, Shizuoka, Japan.
¹³ Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan.
¹⁴ Department of Orthopaedics and Rehabilitation Medicine, Faculty of Medical Sciences University of Fukui, Yoshida-gun, Japan.
¹⁵ Department of Orthopaedic Surgery, Hamamatsu University School of Medicine, Hamamatsu City, Japan.
¹⁶ Department of Orthopaedic Surgery, Nagoya Kyoritsu Hospital, Nagoya-shi, Japan.
¹⁷ Department of Orthopaedic Surgery, Yamaguchi University Graduate School of Medicine, Ube City, Japan.
¹⁸ Department of Orthopaedic Surgery, Shinshu University School of Medicine, Matsumoto, Japan.
¹⁹ Department of Orthopaedics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan.
²⁰ Department of Orthopaedics, Saiseikai Shiga Hospital, Shiga, Japan.
²¹ Department of Orthopedic Surgery, Tohoku University Graduate School of Medicine, Sendai, Japan.
²² Department of Orthopedic Surgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
²³ Department of Orthopedic Surgery, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan.
²⁴ Department of Orthopedic Surgery, Nihon University Hospital, Chiyoda-ku, Japan.
²⁵ Department of Orthopedic Surgery, Nihon University School of Medicine, Itabashi-ku, Japan.
²⁶ Department of Orthopedics, Traumatology and Spine Surgery, Kawasaki Medical School, Kurashiki, Japan.
²⁷ Department of Orthopedic Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan.
²⁸ Department of Orthopaedic Surgery, Kitasato University School of Medicine, Sagamihara, Japan.
²⁹ Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.
³⁰ Department of Orthopaedic Surgery, Kochi Medical School, Kochi University, Nankoku, Japan.
³¹ Department of Orthopaedic Surgery, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan.
³² Department of Orthopaedic Surgery, Graduate School of Medicine, Gunma University, Maebashi, Japan.
³³ Department of Orthopaedic Surgery, Mie University Graduate School of Medicine, Tsu City, Japan.
³⁴ Department of Orthopaedic Surgery, School of Medicine, International University of Health and Welfare, Narita, Japan.
³⁵ Department of Orthopaedic Surgery, International University of Health and Welfare Narita Hospital, Narita, Japan.
³⁶ Department of Orthopaedic Surgery and Spine and Spinal Cord Center, International University of Health and Welfare Mita Hospital, Minato-ku, Japan.
³⁷ Department of Orthopaedic Surgery, The University of Tokyo Hospital, Bunkyo-ku, Japan.
³⁸ Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, Suita, Japan.
³⁹ Department of Orthopedics Surgery, Surgical Science, Tokai University School of Medicine, Isehara, Japan.
⁴⁰ Department of Orthopaedic Surgery, Tokyo Medical and Dental University, Bunkyo-Ku, Japan.
⁴¹ Department of Orthopaedic Surgery, University of Yamanashi, Chuo, Japan.
⁴² Department of Orthopaedic Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
⁴³ Department of Orthopaedic Surgery, Faculty of Medicine, University of Toyama, Toyama, Japan.
⁴⁴ Department of Orthopaedic Surgery, Faculty of Medicine, Oita University, Oita, Japan.
⁴⁵ Department of Orthopaedic Surgery, Kansai Medical University Hospital, Hirakata, Osaka, Japan.

PMID: 35617466
PMCID: PMC10676156
DOI: 10.1177/21925682221095470

Abstract

Study design: Retrospective Cohort Study.

Objective: The purpose of this study was to investigate the prognosis of respiratory function in elderly patients with cervical spinal cord injury (SCI) and to identify predictive factors.

Methods: We included 1353 cases of elderly cervical SCI patients collected from 78 institutions in Japan. Patients who required early tracheostomy and ventilator management and those who developed respiratory complications were defined as the respiratory disability group. Patients' background characteristics, injury mechanism, injury form, neurological disability, complications, and treatment methods were compared between the disability and non-disability groups. Multiple logistic regression analysis was used to examine the independent factors. Patients who required respiratory management for 6 months or longer after injury and those who died of respiratory complications were classified into the severe disability group and were compared with minor cases who were weaned off the respirator.

Results: A total of 104 patients (7.8%) had impaired respiratory function. Comparisons between the disabled and non-disabled groups and between the severe and mild injury groups yielded distinct trends. In multiple logistic regression analysis, age, blood glucose level, presence of ossification of posterior longitudinal ligament (OPLL), anterior vertebral hematoma, and critical paralysis were selected as independent risk factors.

Conclusion: Age, OPLL, severe paralysis, anterior vertebral hematoma, hypoalbuminemia, and blood glucose level at the time of injury were independent factors for respiratory failure. Hyperglycemia may have a negative effect on respiratory function in this condition.

Keywords: cervical spinal cord injury; hyperglycemia; respiratory dysfunction; risk factor.

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Conflict of interest statement

Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

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Prognostic Factors for Respiratory Dysfunction for Cervical Spinal Cord Injury and/or Cervical Fractures in Elderly Patients: A Multicenter Survey

Affiliations

Prognostic Factors for Respiratory Dysfunction for Cervical Spinal Cord Injury and/or Cervical Fractures in Elderly Patients: A Multicenter Survey

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Conflict of interest statement

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