Abstract
Study design
Retrospective study.
Objectives
To determine prevalence of respiratory complications in individuals with spinal cord injury (SCI) during the initial rehabilitation at the spinal cord injury unit (SCU) and to describe the subsequent effect on mortality.
Setting
The SCU at the university hospital in Gothenburg, Sweden.
Methods
We reviewed the medical charts of newly injured persons with SCI who were admitted to the SCU between 1/1/2010 and 12/31/2014. Outcome measures were time to death, length of stay, occurrence of respiratory complications, and the use of breathing aids.
Results
A total of 136 consecutive individuals were included; 53% with cervical SCI and 20% with lower SCI suffered from one or several respiratory complications during their initial rehabilitation in the SCU. At follow-up, 10/1/2018, 20% of the individuals were deceased. The most common cause of death was related to respiratory insufficiency. The individuals with respiratory complications during the initial rehabilitation in the SCU had particularly shortened survival compared with those without. The relative risk (RR) of dying if the person suffered from any respiratory complications during their initial rehabilitation in the SCU was 2.1 times higher than for those with no respiratory complications (RR, 2.1; 95% CI, 1.1–3.9).
Conclusions
Having respiratory complications at the SCU provides preliminary data to support the claim that respiratory complications predict premature mortality. Early diagnosis and prophylactic measures seem to be necessary to mitigate the adverse consequences of serious respiratory problems.
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Data availability
The datasets analysed during the present study are not publicly available due to Swedish regulation (https://etikprovningsmyndigheten.se/for-forskare/vad-sager-lagen/) that state that data cannot be made available for more than what has been approved by the Ethical Review Board. The datasets generated and/or analyzed during the current study are available from the corresponding author on reasonable request.
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Funding
This research was supported by a grant from the Sahlgrenska University Hospital Foundation and Hjalmar Svensson Foundation. The study was financed by grants from the Swedish state under the agreement between the Swedish government and County Councils, ALF agreement 71980 (KSS).
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Contributions
CJ collected data, conducted the statistical analysis with assistance from statistician Thomas Karlsson, and was responsible for writing the paper. TR, ÅLN, and KSS contributed to the study design and the writing and editing of the paper. All contributors have read and approved the final version of the paper.
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Conflict of interest
The authors declare that they have no conflict of interest.
Ethical approval
The regional ethical review board in Gothenburg gave ethical approval (reference numbers 383–17 and T560–18) according to the guidelines of the Declaration of Helsinki. Clinical data collected during the inclusion period did not require informed consent according to Swedish law on personal data (The Personal Data Act, Swedish law No. SFS 1998:2014).
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Josefson, C., Rekand, T., Lundgren-Nilsson, Å. et al. Respiratory complications during initial rehabilitation and survival following spinal cord injury in Sweden: a retrospective study. Spinal Cord 59, 659–664 (2021). https://doi.org/10.1038/s41393-020-00549-6
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DOI: https://doi.org/10.1038/s41393-020-00549-6
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