Risk Factors for Dysphagia After Traumatic Cervical Spinal Cord Injury: A Retrospective Study

Abstract

Objective: To identify risk factors for dysphagia in individuals who sustained traumatic cervical SCI. The pathophysiologic mechanisms of dysphagia in individuals with traumatic cervical spinal cord injury (SCI) are not well understood yet. Several risk factors for developing dysphagia after SCI were postulated including mechanical ventilation, tracheostomy, age, female sex, anterior surgical approach, SCI severity, and multilevel spinal fusion.

Design: Retrospective analysis: Candidate explanatory variables, including injury severity, age, neurological level of injury, surgical approach, number of fused spinal segments, and tracheostomy including its type, were analyzed using univariate and multivariable statistical analyses.

Setting: We included patients, who were treated at the BG Trauma Center Murnau between 2013 and 2022.

Participants: Datasets of a total of 407 patients with traumatic cervical SCI were included.

Main outcome measures: Dysphagia prevalence and identification of associated risk factors.

Results: Our analysis included 407 individuals, of whom 22.6% had dysphagia. Tracheostomy and age were identified as the main risk factors for dysphagia after traumatic cervical SCI. Contrary to previous literature, injury severity, an anterior surgical approach, the type of tracheostomy, a higher neurological level of SCI, and multilevel spinal fusion did not show an increased risk after accounting for other factors.

Conclusions: Our study identifies age and tracheostomy as primary risk factors for dysphagia after SCI, allowing to identify patients at risk and inform early-stage clinical management.

Keywords: Dysphagia; Rehabilitation; Risk factors; Spinal cord injuries; Swallowing disorders.