Long-term trends and risk factors of tracheostomy and decannulation in patients with cervical spinal cord Injury

Lianjun Gao; Wei Gao; Hongwei Liu; Changbin Liu; Feng Yang; Qimin Wang; Weichao Zhao; Zhaohui Tong

doi:10.1038/s41393-024-00968-9

Long-term trends and risk factors of tracheostomy and decannulation in patients with cervical spinal cord Injury

Spinal Cord. 2024 Mar 30. doi: 10.1038/s41393-024-00968-9. Online ahead of print.

Authors

Lianjun Gao^{1

2}, Wei Gao², Hongwei Liu³, Changbin Liu⁴, Feng Yang², Qimin Wang², Weichao Zhao^{1

5}, Zhaohui Tong⁶

Affiliations

¹ Department of Respiratory and Critical Care Medicine, Beijing Institute of Respiratory Medicine, Beijing Chao-yang Hospital, Capital Medical University, Beijing, China.
² Department of Respiratory and Critical Care Medicine, Beijing Bo'ai Hospital, China Rehabilitation Research Center, Capital Medical University, Beijing, China.
³ Department of Spinal and Neural Function Reconstruction, Beijing Bo'ai Hospital, China Rehabilitation Research Center, Beijing, China.
⁴ Department of Rehabilitation Medicine, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
⁵ Department of Respiratory Medicine, PLA Strategic Support Force Medical Center, Beijing, China.
⁶ Department of Respiratory and Critical Care Medicine, Beijing Institute of Respiratory Medicine, Beijing Chao-yang Hospital, Capital Medical University, Beijing, China. tongzhaohuicy@sina.com.

PMID: 38555388
DOI: 10.1038/s41393-024-00968-9

Abstract

Study design: Retrospective study.

Objectives: To investigate the risk factors of tracheostomy and decannulation after cervical spinal cord injury (CSCI) and their epidemiological changes over the past 8 years in Beijing Bo'ai Hospital, China Rehabilitation Research Center (CRRC), China.

Setting: Beijing Bo'ai Hospital, CRRC.

Methods: We reviewed 8 years of patient data (2013.1.1 to 2020.12.31) at CRRC, focusing on those hospitalized and diagnosed with CSCI. We analyzed changes in demographic and clinical data's trends. Logistic regression analysis was used to determine factors impacting tracheostomy and decannulation.

Results: Finally, 1641 CSCI patients met the inclusion criteria. Over the past 8 years, the proportion of tracheostomized patients with CSCI was 16.3%, and the proportion of successfully decannulated of tracheostomized patients with TCSCI was 77.9%. We found that Traumatic (OR = 1.8, 95% CI = 1.06, 3.22; p = 0.046), Motor level of injury (C5-C8) (OR = 0.32, 95% CI = -1.91,-0.34; p = 0.005), AIS = A/B/C (OR = 22.7/11.1/4.2, 95% CI = 12.16,42.26/5.74,21.56/2.23,7.89; p < 0.001/p < 0.001/p < 0.001), age > 56 (OR = 1.6, 95% CI = 1.04, 2.32; p = 0.031) were the risk factors for tracheostomy. By analyzing the risk factors of decannulation failure in tracheostomized patients with TCSCI through multivariable logistic regression, statistically significant differences were found in age > 45 (OR = 4.1, 95% CI = 1.44, 11.81; p = 0.008), complete injury (OR = 2.7, 95% CI = 1.26, 5.95; p = 0.011), facet dislocation (OR = 2.8, 95% CI = 1.13,7.07; p = 0.027).

Conclusions: Recent years have witnessed shifts in the epidemiological characteristics of CSCI. Identifying the factors influencing tracheostomy and decannulation in CSCI can aid in improving patient prognosis.