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创伤性颈脊髓损伤后吞咽困难的危险因素:一项回顾性研究。

Risk Factors for Dysphagia After Traumatic Cervical Spinal Cord Injury: A Retrospective Study.

作者信息

Meißner Iris, Dietmann Stephanie, Hüller Gerrit, Mach Orpheus, Vogel Matthias, Ehret Matthias, Scheel-Sailer Anke, Aigner Ludwig, Maier Doris, Leister Iris

机构信息

Spinal Cord Injury Center, BG Trauma Center Murnau, Murnau, Germany; ParaMove, SCI Research Unit, BG Trauma Center Murnau, Murnau, Germany.

Spinal Cord Injury Center, BG Trauma Center Murnau, Murnau, Germany.

出版信息

Arch Phys Med Rehabil. 2025 Aug;106(8):1189-1197. doi: 10.1016/j.apmr.2024.12.014. Epub 2024 Dec 28.

Abstract

OBJECTIVE

To identify risk factors for dysphagia in individuals who sustained traumatic cervical SCI. The pathophysiologic mechanisms of dysphagia in individuals with traumatic cervical spinal cord injury (SCI) are not well understood yet. Several risk factors for developing dysphagia after SCI were postulated including mechanical ventilation, tracheostomy, age, female sex, anterior surgical approach, SCI severity, and multilevel spinal fusion.

DESIGN

Retrospective analysis: Candidate explanatory variables, including injury severity, age, neurological level of injury, surgical approach, number of fused spinal segments, and tracheostomy including its type, were analyzed using univariate and multivariable statistical analyses.

SETTING

We included patients, who were treated at the BG Trauma Center Murnau between 2013 and 2022.

PARTICIPANTS

Datasets of a total of 407 patients with traumatic cervical SCI were included.

MAIN OUTCOME MEASURES

Dysphagia prevalence and identification of associated risk factors.

RESULTS

Our analysis included 407 individuals, of whom 22.6% had dysphagia. Tracheostomy and age were identified as the main risk factors for dysphagia after traumatic cervical SCI. Contrary to previous literature, injury severity, an anterior surgical approach, the type of tracheostomy, a higher neurological level of SCI, and multilevel spinal fusion did not show an increased risk after accounting for other factors.

CONCLUSIONS

Our study identifies age and tracheostomy as primary risk factors for dysphagia after SCI, allowing to identify patients at risk and inform early-stage clinical management.

摘要

目的

确定创伤性颈髓损伤患者吞咽困难的危险因素。创伤性颈髓损伤(SCI)患者吞咽困难的病理生理机制尚未完全明确。推测SCI后发生吞咽困难的几个危险因素包括机械通气、气管切开术、年龄、女性、前路手术入路、SCI严重程度和多节段脊柱融合术。

设计

回顾性分析:使用单变量和多变量统计分析对候选解释变量进行分析,这些变量包括损伤严重程度、年龄、神经损伤平面、手术入路、融合脊柱节段数以及气管切开术(包括其类型)。

地点

我们纳入了2013年至2022年期间在BG陶努斯山创伤中心接受治疗的患者。

参与者

共纳入407例创伤性颈髓损伤患者的数据集。

主要观察指标

吞咽困难的患病率及相关危险因素的识别。

结果

我们的分析纳入了407例个体,其中22.6%有吞咽困难。气管切开术和年龄被确定为创伤性颈髓损伤后吞咽困难的主要危险因素。与既往文献相反,在考虑其他因素后,损伤严重程度、前路手术入路、气管切开术类型、更高的SCI神经平面和多节段脊柱融合术并未显示出风险增加。

结论

我们的研究确定年龄和气管切开术是SCI后吞咽困难的主要危险因素,有助于识别有风险的患者并为早期临床管理提供信息。

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