Rehabilitation Medicine Center and Institute of Rehabilitation Medicine, West China Hospital, Sichuan University, No.37 Guoxue Alley, Chengdu, Sichuan Province, 610041, PR China.
Department of Rehabilitation Medicine, Division of Life Sciences and Medicine, The First Affiliated Hospital of USTC, University of Science and Technology of China, No.1 Swan Lake Road, Hefei, Anhui Province, 230031, PR China.
BMC Pulm Med. 2024 Oct 18;24(1):520. doi: 10.1186/s12890-024-03332-y.
Patients with spinal cord injury (SCI) are at higher risk of developing pulmonary infection (PI), and plasma fibrinogen level may be an independent risk factor for PI. However, the relationship between fibrinogen level and PI incidence in the SCI population remains unclear. This study aimed to elucidate the association between plasma fibrinogen level and the occurrence of PI among SCI patients.
We conducted a retrospective analysis of 576 SCI patients admitted to the Rehabilitation Medicine Department between January 1, 2017, and December 31, 2021. Following exclusions, 491 patients were included in the final analysis, with 139 PI cases identified.
Surgery, level of injury and chest comorbidities were covariates in the relationship between fibrinogen level and PI incidence. Other identified potential risk factors for PI included age, D-dimer level, urinary tract infections (UTI), deep vein thrombosis (DVT), anticoagulant therapy, injury mechanism, and the American Spinal Injury Association Impairment Scale (AIS) grades. After adjusting for these factors, we found that for every 1 g/L increase in fibrinogen level, the risk of developing PI increased by 18% (HR = 1.18, P = 0.011), and indicating a positive linear relationship between fibrinogen level and PI incidence.
Plasma fibrinogen was an independent risk factor for PI in patients with SCI, especially for AIS-B and C grades. Proactive management of fibrinogen level after admission to rehabilitation medicine department could be crucial in reducing the incidence of PI in this vulnerable population.
Not applicable.
脊髓损伤（SCI）患者发生肺部感染（PI）的风险较高，血浆纤维蛋白原水平可能是 PI 的独立危险因素。然而，SCI 人群中纤维蛋白原水平与 PI 发生率之间的关系尚不清楚。本研究旨在阐明血浆纤维蛋白原水平与 SCI 患者 PI 发生之间的关系。
我们对 2017 年 1 月 1 日至 2021 年 12 月 31 日期间在康复医学科住院的 576 例 SCI 患者进行了回顾性分析。排除后，最终有 491 例患者纳入了最终分析，其中有 139 例发生了 PI。
手术、损伤水平和胸部合并症是纤维蛋白原水平与 PI 发生率之间关系的协变量。其他确定的 PI 潜在危险因素包括年龄、D-二聚体水平、尿路感染（UTI）、深静脉血栓形成（DVT）、抗凝治疗、损伤机制和美国脊髓损伤协会损伤分级（AIS）。在调整这些因素后，我们发现纤维蛋白原水平每增加 1g/L，发生 PI 的风险增加 18%（HR=1.18，P=0.011），表明纤维蛋白原水平与 PI 发生率之间存在正线性关系。
血浆纤维蛋白原是 SCI 患者发生 PI 的独立危险因素，尤其是对于 AIS-B 和 C 级患者。在康复医学科住院后积极管理纤维蛋白原水平可能对降低该脆弱人群的 PI 发生率至关重要。
不适用。
