OBJECTIVE: 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.
METHODS: 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.
目的:探讨北京博爱医院近8年颈脊髓损伤(CSCI)后气管切开拔管的危险因素及其流行病学变化,中国康复研究中心,中国。
方法:北京博爱医院,中车。
方法:我们回顾了中车8年的患者数据(2013.1.1至2020.12.31),重点关注那些住院和诊断为CSCI的人。我们分析了人口统计学和临床数据的变化趋势。Logistic回归分析用于确定影响气管切开和拔管的因素。
结果:最后,1641例CSCI患者符合纳入标准。在过去的8年里,CSCI气管切开患者的比例为16.3%,TSCI气管切开患者成功拔管的比例为77.9%。我们发现创伤(OR=1.8,95%CI=1.06,3.22;p=0.046),运动损伤水平(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),年龄>56(OR=1.6,95%CI=1.04,2.32;p=0.031)是气管切开的危险因素。通过多因素logistic回归分析TSCI患者气管切开拔管失败的危险因素,年龄>45岁时差异有统计学意义(OR=4.1,95%CI=1.44,11.81;p=0.008),完全损伤(OR=2.7,95%CI=1.26,5.95;p=0.011),小面位错(OR=2.8,95%CI=1.13,7.07;p=0.027)。
结论:近年来,CSCI的流行病学特征发生了变化。确定CSCI中影响气管切开和拔管的因素有助于改善患者预后。