Xie Yongqi, Zhao Weichao, Peng Run, Zhang Liang, Jia Yunxiao, Yang Mingliang, Gao Lianjun
School of Rehabilitation Medicine, Capital Medical University, Beijing, China.
Department of Rehabilitation Medicine, Foshan Hospital of Traditional Chinese Medicine, Foshan, China.
Spinal Cord. 2025 Jan;63(1):43-48. doi: 10.1038/s41393-024-01048-8. Epub 2024 Nov 19.
Retrospective study.
To investigate the outcomes and influencing factors of tracheostomy decannulation (TD) in persons with traumatic cervical spinal cord injury (SCI).
China Rehabilitation Research Center (CRRC) in Beijing, China.
From January 2017 to December 2021, 365 persons with traumatic cervical SCI were admitted to the China Rehabilitation Research Center. During hospitalization, tracheostomy patients were enrolled and divided into the TD group and non-TD group. Demographic and clinical data, as well as functional assessments, were collected and recorded for all persons. The factors influencing TD were analyzed using both univariate and multivariate logistic regression.
A total of 78 persons with traumatic cervical SCI from CRRC were enrolled in this study. Of these, 48 persons (61.5%) underwent successful decannulation, with a median time of 93.5 days (IQR: 62.0-143.8 days). Multivariate logistic regression revealed that AIS A (P = 0.021, OR: 5.378, 95% CI, 1.287-22.474) and Charlson comorbidity index (CCI) (P = 0.003, OR: 1.836, 95% CI, 1.230-2.740) were significant risk factors of reduced success in TD. PEF in the TD group was 145.44 ± 50.56 L/min. Middle-aged and young persons with traumatic cervical SCI at C3 to C5 neurological level did not satisfy the criterion of PEF (over 160 L/min), but they can still attempt tracheostomy decannulation.
AIS A and a high CCI will reduce the success rate of tracheostomy decannulation in persons suffering from traumatic cervical SCI.
回顾性研究。
探讨创伤性颈脊髓损伤（SCI）患者气管切开拔管（TD）的结局及影响因素。
中国北京的中国康复研究中心（CRRC）。
2017年1月至2021年12月，365例创伤性颈SCI患者入住中国康复研究中心。住院期间，纳入气管切开患者并分为TD组和非TD组。收集并记录所有患者的人口统计学和临床数据以及功能评估结果。采用单因素和多因素logistic回归分析影响TD的因素。
本研究共纳入中国康复研究中心78例创伤性颈SCI患者。其中，48例（61.5%）成功拔管，中位时间为93.5天（四分位间距：62.0 - 143.8天）。多因素logistic回归显示，美国脊髓损伤协会（AIS）分级A（P = 0.021，比值比：5.378，95%置信区间，1.287 - 22.474）和查尔森合并症指数（CCI）（P = 0.003，比值比：1.836，95%置信区间，1.230 - 2.740）是TD成功率降低的显著危险因素。TD组的最大呼气流量（PEF）为145.44±50.56升/分钟。C3至C5神经平面的中青年创伤性颈SCI患者未达到PEF标准（超过160升/分钟），但仍可尝试气管切开拔管。
AIS分级A和高CCI会降低创伤性颈SCI患者气管切开拔管的成功率。
