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A Meta-Analysis of the Influencing Factors for Tracheostomy after Cervical Spinal Cord Injury.
- Source :
- BioMed Research International; 7/12/2018, Vol. 2018, p1-10, 10p
- Publication Year :
- 2018
-
Abstract
- Background. Traumatic cervical spinal cord injury (CSCI) is a common disease that has high complication, disability, and mortality rates and a poor prognosis. Tracheostomy is an important supportive therapy for patients with CSCI. However, a consensus on the predictive factors for tracheostomy after CSCI has not been reached. Objective. This meta-analysis study assessed the influencing factors for tracheostomy after CSCI. Methods. We searched for relevant studies on the influencing factors for tracheostomy after CSCI. The extracted data were analyzed using RevMan 5.3 software. We calculated the odds ratio (OR) or mean difference (MD) and 95% confidence intervals (CIs). Results. Sixteen eligible studies containing 9697 patients with CSCI were selected. The pooled OR (MD) and 95% CI of the influencing factors were as follows: age (mean ± SD): -0.98 (-4.00 to 2.03), advanced age: 1.93 (0.80 to 4.63), sex (male): 1.29 (1.12 to 1.49), American Spinal Injury Association Impairment Scale (AIS) A grade: 7.79 (5.28 to 11.50), AIS B grade: 1.15 (1.13 to 2.02), AIS C grade: 0.28 (0.20 to 0.41), AIS D grade: 0.04 (0.02 to 0.09), neurological level of injury (upper CSCI): 2.36 (1.51 to 3.68), injury severity score (ISS): 8.97 (8.11 to 9.82), Glasgow Coma Scale (GCS) score ≤8: 6.03 (2.19 to 16.61), thoracic injury: 1.78 (1.55 to 2.04), brain injury: 0.96 (0.55 to 1.69), respiratory complications: 5.97 (4.03 to 8.86), smoking history: 1.45 (0.99 to 2.13), traffic accident injury: 1.27 (0.92 to 1.74), and fall injury: 0.72 (0.52 to 1.01). Conclusions. The current evidence shows that male sex, AIS A grade, AIS B grade, neurological level of injury (upper CSCI), high ISS, GCS≤8, thoracic injury, and respiratory complications are risk factors for tracheostomy after CSCI, and AIS C grade and AIS D grade are protective factors. This study will allow us to use these factors for tracheostomy decisions and ultimately optimize airway management in patients with CSCI. [ABSTRACT FROM AUTHOR]
- Subjects :
- CERVICAL vertebrae injuries
AGE distribution
AIRWAY (Anatomy)
BRAIN injuries
CHEST injuries
CONFIDENCE intervals
ACCIDENTAL falls
META-analysis
RESPIRATORY diseases
SEX distribution
SMOKING
SPINAL cord injuries
SURGICAL complications
TRACHEOTOMY
TRAFFIC accidents
SYSTEMATIC reviews
SEVERITY of illness index
DATA analysis software
GLASGOW Coma Scale
ODDS ratio
Subjects
Details
- Language :
- English
- ISSN :
- 23146133
- Volume :
- 2018
- Database :
- Complementary Index
- Journal :
- BioMed Research International
- Publication Type :
- Academic Journal
- Accession number :
- 130658496
- Full Text :
- https://doi.org/10.1155/2018/5895830