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. 2022 Oct 28;7(3):219-224.
doi: 10.22603/ssrr.2022-0158. eCollection 2023 May 27.

Time Course and Characteristics of the Nutritional Conditions in Acute Traumatic Cervical Spinal Cord Injury

Tetsuo Hayashi  1   2 , Yuichi Fujiwara  3 , Muneaki Masuda  2 , Kensuke Kubota  1   2 , Hiroaki Sakai  2 , Osamu Kawano  2 , Yuichiro Morishita  2 , Kazuya Yokota  2 , Takeshi Maeda  2
Affiliations

Time Course and Characteristics of the Nutritional Conditions in Acute Traumatic Cervical Spinal Cord Injury

Tetsuo Hayashi et al. Spine Surg Relat Res. .

Abstract

Introduction: This retrospective cohort study aimed to examine the nutritional time course and elucidate the critical period of undernutrition following acute traumatic cervical spinal cord injury (CSCI).

Methods: The study was performed at a single facility that treated spinal cord injuries. We examined individuals with acute traumatic CSCI admitted to our hospital within 3 days of injury. Both prognostic nutritional index (PNI) and controlling nutritional status (CONUT) scores, which objectively reflect nutritional and immunological conditions, were assessed at admission and 1, 2, and 3 months after the injury. The American Spinal Injury Association impairment scale (AIS) categorizations and severity of dysphagia were evaluated at these time points.

Results: A total of 106 patients with CSCI were evaluated consecutively for 3 months after injury. Individuals with AIS categorizations of A, B, or C at 3 days after injury were significantly more undernourished than those with an AIS categorization of D at 3 months after injury, indicating that individuals with mild paresis better maintained their nutritional condition after injury. Nutritional conditions, as assessed by both PNI and CONUT scores, improved significantly between 1 and 2 months after injury, whereas no significant differences were found between admission and 1 month after injury. Nutritional status and dysphagia were significantly correlated at each time point (p<0.001), indicating that swallowing dysfunction is an important factor associated with malnutrition.

Conclusions: Nutritional conditions showed significant gradual improvements from 1 month after the injury. We must pay attention to undernutrition, which is associated with dysphagia, especially in individuals with severe paralysis during the acute phase following injury.

Keywords: Cervical spinal cord injury; Complication; Dysphagia; Nutrition; Paresis.

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Conflict of interest statement

Conflicts of Interest: The authors declare that there are no relevant conflicts of interest. The submitted manuscript does not contain any information about medical device(s)/drug(s).

Figures

Figure 1.
Figure 1.
Flow chart of the study CSCI: cervical spinal cord injury.
Figure 2.
Figure 2.
Prognostic nutritional index (A) and CONUT (B) score 3 months after injury in each AIS categorization at admission. The nutritional conditions 3 months after injury in individuals with an AIS categorization of D were significantly better than that in individuals with AIS categorizations of A, B, and C. AIS: American Spinal Injury Association impairment scale; CONUT: controlling nutritional status
Figure 3.
Figure 3.
Time course of the nutritional condition. The nutritional condition, evaluated using PNI and CONUT scores (A, B), improved significantly from 1 month after the injury. PNI and CONUT scores within each AIS categorization (C, D) also gradually improved 3 months after the injury. AIS: American Spinal Injury Association impairment scale; CONUT: controlling nutritional status; PNI, prognostic nutritional index
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References

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