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

Spinal Cord (2024)Cite this article

Subjects

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.

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Data availability

The dataset generated and analyzed during the current study is available from the corresponding author on reasonable request.

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Acknowledgements

We thank Prof. Li-Rong Liang & Dr. Pen-Kun Li for their statistical analysis assistance.

Funding

This work was supported by grants from China Rehabilitation Research Center (No. 2023ZX-Q12); National Natural Science Foundation of China, No. 82102676.

Author information

Authors and Affiliations

  1. Department of Respiratory and Critical Care Medicine, Beijing Institute of Respiratory Medicine, Beijing Chao-yang Hospital, Capital Medical University, Beijing, China

    Lianjun Gao, Weichao Zhao & Zhaohui Tong

  2. Department of Respiratory and Critical Care Medicine, Beijing Bo’ai Hospital, China Rehabilitation Research Center, Capital Medical University, Beijing, China

    Lianjun Gao, Wei Gao, Feng Yang & Qimin Wang

  3. Department of Spinal and Neural Function Reconstruction, Beijing Bo’ai Hospital, China Rehabilitation Research Center, Beijing, China

    Hongwei Liu

  4. Department of Rehabilitation Medicine, Beijing Tiantan Hospital, Capital Medical University, Beijing, China

    Changbin Liu

  5. Department of Respiratory Medicine, PLA Strategic Support Force Medical Center, Beijing, China

    Weichao Zhao

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  1. Lianjun Gao
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Contributions

LG was responsible for designing the review protocol, writing the protocol and report, conducting the research, screening potentially eligible patients, extracting and analyzing data, interpreting results, submitting the study to the ethics committee, updating reference lists and writing the first draft of the manuscript. WG was contributed to writing the report, extracting and analyzing data, interpreting results. HL and CHL were responsible for collecting data, analyzing data, graphing and creating tables. FY and WZH was responsible for arbitrating potentially eligible studies, revised the manuscript for important intellectual content. QW contributed to writing the report, providing important references and interpreting results. ZHT was responsible for supervising the research protocol and providing feedback on the report. He is the corresponding author. All authors approved the final manuscript.

Corresponding author

Correspondence to Zhaohui Tong.

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Competing interests

The authors declare no competing interests.

Ethical approval

Approval from the hospital ethics committee was obtained before commencing the study (No. CRRC-IEC-RF-SC-002-01).

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Gao, L., Gao, W., Liu, H. et al. Long-term trends and risk factors of tracheostomy and decannulation in patients with cervical spinal cord Injury. Spinal Cord (2024). https://doi.org/10.1038/s41393-024-00968-9

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  • DOI: https://doi.org/10.1038/s41393-024-00968-9

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