Mu Zhiping, Zhang Zhengfeng
Department of Orthopedics, Xinqiao Hospital, Third Military Medical University, Chongqing, China.
J Orthop Surg (Hong Kong). 2019 Sep-Dec;27(3):2309499019861809. doi: 10.1177/2309499019861809.
To determine the risk factors for the need of tracheostomy after cervical spinal cord injury (CSCI) at the acute stage.
The authors retrospectively reviewed 294 patients with acute traumatic CSCI in Xinqiao Hospital between 2012 and 2016 and analyzed the factors postulated to increase the risk for tracheostomy, including patient's age, neurological impairment scale grade and level, smoking history, combined injury, and surgical intervention. Logistic regression analysis was used to identify independent risk factor for the need of tracheostomy.
Of 294 patients, 52 patients received tracheostomy (17.7%). The factor identified by demographics and outcomes were smoking history, cause of injury, neurological impairment scale grade and level, and combined dislocation. A multiple logistic regression model demonstrated that age of 60 years older, combined facet dislocation, C4 level high, and the American Spinal Injury Association (ASIA) A and B scale were predictive of need for tracheostomy on 95% occasions.
The high age of 60 years, combined facet dislocation, C4 level high, and ASIA A and B scale are indispensable to predict the need for tracheostomy in patients with CSCI at the acute stage.
确定急性颈脊髓损伤（CSCI）患者急性期行气管切开术的危险因素。
作者回顾性分析了2012年至2016年新桥医院收治的294例急性创伤性CSCI患者，分析了可能增加气管切开术风险的因素，包括患者年龄、神经功能缺损量表分级和损伤平面、吸烟史、合并伤以及手术干预。采用Logistic回归分析确定气管切开术需求的独立危险因素。
294例患者中，52例接受了气管切开术（17.7%）。通过人口统计学和预后确定的因素为吸烟史、损伤原因、神经功能缺损量表分级和损伤平面以及合并脱位。多元Logistic回归模型显示，年龄≥60岁、合并关节突关节脱位、C4及以上损伤平面以及美国脊髓损伤协会（ASIA）A、B级在95%的情况下可预测气管切开术需求。
年龄≥60岁、合并关节突关节脱位、C4及以上损伤平面以及ASIA A、B级是预测急性CSCI患者气管切开术需求不可或缺的因素。
