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

Naoki Segi¹, Hiroaki Nakashima¹, Sadayuki Ito¹, Jun Ouchida¹, Noriaki Yokogawa², Takeshi Sasagawa^{2

3}, Toru Funayama⁴, Fumihiko Eto⁵, Kota Watanabe⁶, Satoshi Nori⁶, Takeo Furuya⁷, Atsushi Yunde⁷, Yoshinori Terashima^{8

9}, Ryosuke Hirota⁸, Hideaki Nakajima¹⁰, Tomohiro Yamada^{11

12}, Tomohiko Hasegawa¹¹, Kenichi Kawaguchi¹³, Yohei Haruta¹³, Ko Hashimoto¹⁴, Yoshito Onoda¹⁴, Kazuo Nakanishi¹⁵, Kosuke Misaki¹⁵, Shota Ikegami¹⁶, Masashi Uehara¹⁶, Hidenori Suzuki¹⁷, Yasuaki Imajo¹⁷, Hiroshi Uei^{18

19}, Hirokatsu Sawada¹⁹, Hidetomi Terai²⁰, Koji Tamai²⁰, Akiyoshi Kuroda²¹, Gen Inoue²¹, Nobuyuki Suzuki²², Kenji Kato²², Koji Akeda²³, Norihiko Takegami²³, Yoichi Iizuka²⁴, Yasushi Oshima²⁵, Hitoshi Tonomura²⁶, Katsuhito Kiyasu²⁷, Haruki Funao^{28

29

30}, Toshitaka Yoshii³¹, Masayuki Ishihara³², Takashi Kaito³³, Shoji Seki³⁴, Kenichiro Kakutani³⁵, Hiroyuki Tominaga³⁶, Tetsuro Ohba³⁷, Daisuke Sakai³⁸, Bungo Otsuki³⁹, Masashi Miyazaki⁴⁰, Seiji Okada³³, Shiro Imagama¹, Satoshi Kato²

Affiliations

¹ Department of Orthopedic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan.
² Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa University, Kanazawa, Japan.
³ Department of Orthopaedic Surgery, Toyama Prefectural Central Hospital, Toyama, Japan.
⁴ Department of Orthopaedic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan.
⁵ Department of Orthopaedic Surgery, Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Japan.
⁶ Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, Japan.
⁷ Department of Orthopaedic Surgery, Graduate school of Medicine, Chiba University, Chiba, Japan.
⁸ Department of Orthopaedic Surgery, Sapporo Medical University, Sapporo, Japan.
⁹ Department of Orthopaedic Surgery, Matsuda Orthopedic Memorial Hospital, Sapporo, Japan.
¹⁰ Department of Orthopaedics and Rehabilitation Medicine, Faculty of Medical Sciences University of Fukui, Yoshida, Japan.
¹¹ Department of Orthopaedic Surgery, Hamamatsu University School of Medicine, Hamamatsu, Japan.
¹² Department of Orthopaedic Surgery, Nagoya Kyoritsu Hospital, Nagoya, Japan.
¹³ Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
¹⁴ Department of Orthopaedic Surgery, Tohoku University Graduate School of Medicine, Sendai, Japan.
¹⁵ Department of Orthopedics, Traumatology and Spine Surgery, Kawasaki Medical School, Kurashiki, Japan.
¹⁶ Department of Orthopaedic Surgery, Shinshu University School of Medicine, Matsumoto, Japan.
¹⁷ Department of Orthopaedic Surgery, Yamaguchi University Graduate School of Medicine, Ube, Japan.
¹⁸ Department of Orthopaedic Surgery, Nihon University Hospital, Tokyo, Japan.
¹⁹ Department of Orthopaedic Surgery, Nihon University School of Medicine, Tokyo, Japan.
²⁰ Department of Orthopaedic Surgery, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan.
²¹ Department of Orthopaedic Surgery, Kitasato University School of Medicine, Sagamihara, Japan.
²² Department of Orthopaedic Surgery, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan.
²³ Department of Orthopaedic Surgery, Mie University Graduate School of Medicine, Tsu, Japan.
²⁴ Department of Orthopaedic Surgery, Gunma University, Graduate School of Medicine, Maebashi, Japan.
²⁵ Department of Orthopaedic Surgery, The University of Tokyo Hospital, Tokyo, Japan.
²⁶ Department of Orthopaedics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan.
²⁷ Department of Orthopaedic Surgery, Kochi Medical School, Kochi University, Nankoku, Japan.
²⁸ Department of Orthopaedic Surgery, School of Medicine, International University of Health and Welfare, Narita, Japan.
²⁹ Department of Orthopaedic Surgery, International University of Health and Welfare Narita Hospital, Narita, Japan.
³⁰ Department of Orthopaedic Surgery and Spine and Spinal Cord Center, International University of Health and Welfare Mita Hospital, Tokyo, Japan.
³¹ Department of Orthopaedic Surgery, Tokyo Medical and Dental University, Tokyo, Japan.
³² Department of Orthopaedic Surgery, Kansai Medical University Hospital, Hirakata, Japan.
³³ Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, Suita, Japan.
³⁴ Department of Orthopaedic Surgery, Faculty of Medicine, University of Toyama, Toyama, Japan.
³⁵ Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.
³⁶ Department of Orthopaedic Surgery, Graduate School of medical and Dental Sciences, Kagoshima University, Kagoshima, Japan.
³⁷ Department of Orthopaedic Surgery, University of Yamanashi, Chuo, Japan.
³⁸ Department of Orthopedics Surgery, Surgical Science, Tokai University School of Medicine, Isehara, Japan.
³⁹ Department of Orthopaedic Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
⁴⁰ Department of Orthopaedic Surgery, Faculty of Medicine, Oita University, Yufu, Japan.

PMID: 39399453
PMCID: PMC11464830
DOI: 10.22603/ssrr.2023-0227

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

Naoki Segi et al. Spine Surg Relat Res. 2024.

. 2024 Apr 3;8(5):473-479.

doi: 10.22603/ssrr.2023-0227. eCollection 2024 Sep 27.

Authors

Affiliations

¹ Department of Orthopedic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan.
² Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa University, Kanazawa, Japan.
³ Department of Orthopaedic Surgery, Toyama Prefectural Central Hospital, Toyama, Japan.
⁴ Department of Orthopaedic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan.
⁵ Department of Orthopaedic Surgery, Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Japan.
⁶ Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, Japan.
⁷ Department of Orthopaedic Surgery, Graduate school of Medicine, Chiba University, Chiba, Japan.
⁸ Department of Orthopaedic Surgery, Sapporo Medical University, Sapporo, Japan.
⁹ Department of Orthopaedic Surgery, Matsuda Orthopedic Memorial Hospital, Sapporo, Japan.
¹⁰ Department of Orthopaedics and Rehabilitation Medicine, Faculty of Medical Sciences University of Fukui, Yoshida, Japan.
¹¹ Department of Orthopaedic Surgery, Hamamatsu University School of Medicine, Hamamatsu, Japan.
¹² Department of Orthopaedic Surgery, Nagoya Kyoritsu Hospital, Nagoya, Japan.
¹³ Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
¹⁴ Department of Orthopaedic Surgery, Tohoku University Graduate School of Medicine, Sendai, Japan.
¹⁵ Department of Orthopedics, Traumatology and Spine Surgery, Kawasaki Medical School, Kurashiki, Japan.
¹⁶ Department of Orthopaedic Surgery, Shinshu University School of Medicine, Matsumoto, Japan.
¹⁷ Department of Orthopaedic Surgery, Yamaguchi University Graduate School of Medicine, Ube, Japan.
¹⁸ Department of Orthopaedic Surgery, Nihon University Hospital, Tokyo, Japan.
¹⁹ Department of Orthopaedic Surgery, Nihon University School of Medicine, Tokyo, Japan.
²⁰ Department of Orthopaedic Surgery, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan.
²¹ Department of Orthopaedic Surgery, Kitasato University School of Medicine, Sagamihara, Japan.
²² Department of Orthopaedic Surgery, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan.
²³ Department of Orthopaedic Surgery, Mie University Graduate School of Medicine, Tsu, Japan.
²⁴ Department of Orthopaedic Surgery, Gunma University, Graduate School of Medicine, Maebashi, Japan.
²⁵ Department of Orthopaedic Surgery, The University of Tokyo Hospital, Tokyo, Japan.
²⁶ Department of Orthopaedics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan.
²⁷ Department of Orthopaedic Surgery, Kochi Medical School, Kochi University, Nankoku, Japan.
²⁸ Department of Orthopaedic Surgery, School of Medicine, International University of Health and Welfare, Narita, Japan.
²⁹ Department of Orthopaedic Surgery, International University of Health and Welfare Narita Hospital, Narita, Japan.
³⁰ Department of Orthopaedic Surgery and Spine and Spinal Cord Center, International University of Health and Welfare Mita Hospital, Tokyo, Japan.
³¹ Department of Orthopaedic Surgery, Tokyo Medical and Dental University, Tokyo, Japan.
³² Department of Orthopaedic Surgery, Kansai Medical University Hospital, Hirakata, Japan.
³³ Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, Suita, Japan.
³⁴ Department of Orthopaedic Surgery, Faculty of Medicine, University of Toyama, Toyama, Japan.
³⁵ Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.
³⁶ Department of Orthopaedic Surgery, Graduate School of medical and Dental Sciences, Kagoshima University, Kagoshima, Japan.
³⁷ Department of Orthopaedic Surgery, University of Yamanashi, Chuo, Japan.
³⁸ Department of Orthopedics Surgery, Surgical Science, Tokai University School of Medicine, Isehara, Japan.
³⁹ Department of Orthopaedic Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
⁴⁰ Department of Orthopaedic Surgery, Faculty of Medicine, Oita University, Yufu, Japan.

PMID: 39399453
PMCID: PMC11464830
DOI: 10.22603/ssrr.2023-0227

Abstract

Introduction: For older adults, dysphagia is a serious problem that can occur after spinal cord injury (SCI), but its risk factors are unclear. This study aimed to identify risk factors for dysphagia in elderly patients (≥65 years) with cervical SCI.

Methods: This multicenter study included 707 patients with cervical SCI (mean age 75.3 years). Univariate and multivariate analyses were conducted for patient characteristics and geriatric nutritional risk index (GNRI).

Results: Dysphagia occurred in 69 patients (9.8%). The significant factors were as follows: male sex (odds ratio [OR] 3.43), GNRI <92 (1.83), dementia (2.94), fracture (3.40), complete paralysis (3.61), anterior surgery (3.74), and tracheostomy (17.06). Age was not identified as a risk factor.

Conclusions: Low GNRI before injury was one of the independent risk factors for dysphagia after geriatric cervical SCI. GNRI represents the comprehensive nutritional status of the elderly and reflects feeding function and its recovery capacity.

Keywords: cervical spinal cord injury; dysphagia; elderly patients; frailty index; geriatric nutritional risk index.

PubMed Disclaimer

Conflict of interest statement

Conflicts of Interest: The authors declare that there are no relevant conflicts of interest.

Figures

**Figure 1.**
Patient selection flowchart. AIS, American Spinal Injury Association impairment scale; mFI-5, 5-Item Modified Frailty Index; GNRI, geriatric nutritional risk index

See this image and copyright information in PMC

References

1. McRae J, Morgan S, Wallace E, et al. Oropharyngeal dysphagia in acute cervical spinal cord injury: a literature review. Dysphagia. 2023;38(4):1025-38. - PMC - PubMed
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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

Affiliations

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

Authors

Affiliations

Abstract

Conflict of interest statement

Figures

References

LinkOut - more resources

Full Text Sources