Risk factors for respiratory failure with tetraplegia after acute traumatic cervical spinal cord injury

J. Song, J. Shao, H.-H. Qi, D.-W. Song, W. Zhu

Department of Orthopedics, Shanghai Changzheng Hospital, Second Military Medical University  of China, Shanghai, People’s Republic of China. shaojiangmyx@yahoo.com.cn

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• Orthopedics

OBJECTIVE: To analyze risk factors for respiratory failure with tetraplegia after acute traumatic cervical spinal cord injury (CSCI).

PATIENTS AND METHODS: Total 180 tetraplegia cases after acute traumatic CSCI treated in Shanghai Changzheng Hospital from 2001 to 2011 were reviewed retrospectively and the frequency of respiratory failure in these patients were analyzed against the factors including age, gender, cause of injury, level/severity of injury, high-dose methylprednisolone (MP) therapy, and surgery intervention, using Chi-square test to look into the correlations of the prevalence of respiratory failure to those factors.

RESULTS: Of the 180 tetraplegia with acute traumatic CSCI, 29 patients (16.11%) developed respiratory failure. The factors, including age, level and severity of injury, high-dose MP therapy, and surgery intervention, were found to significantly correlate with the appearance of respiratory failure in tetraplegia after acute traumatic CSCI (p < 0.05), while no significant correlation was found between the other factors: gender and cause of injury and the frequency of respiratory failure.

CONCLUSIONS: Age, level/severity of injury, high-dose MP therapy, and surgery intervention are the four major relevant factors of respiratory failure in patients with acute traumatic CSCI. The appropriate and timing treatments involving high-dose MP therapy and surgical decompression and reconstruction can substantially increase the rates of clinical improvements and reduce the frequency of respiratory failure.

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