Time to Mobility Is Associated With Pulmonary Complications in Patients With Spine Fractures

INTRODUCTION: Treatment of spine fractures may require periods of prolonged immobilization which prevents effective pulmonary toileting. We hypothesized that patients with longer time to mobilization, as measured by time to first physical therapy (PT) session, would have higher pulmonary complications.

METHODS: We performed a retrospective review of all trauma patients with cervical and thoracolumbar spinal fractures admitted to a level 1 trauma center over a 12-month period. Demographic data collection included age, gender, BMI, pulmonary comorbidities, concomitant rib fractures, admission GCS, Injury Severity Score (ISS), GCS at 24 h, treatment with cervical or thoracolumbar immobilization, and time to first PT evaluation. The primary outcome was the presence of any one of the following complications: unplanned intubation, pneumonia, or mortality at 30 days. Multivariable logistic regression analysis was used to assess significant predictors of pulmonary complication.

RESULTS: In total, 491 patients were identified. In terms of overall pulmonary complications, 10% developed pneumonia, 13% had unplanned intubation, and 6% died within 30 days. In total, 19% developed one or more complication. Overall, 25% of patients were seen by PT <48 h, 33% between 48 and 96 h, 19% at 96 h to 1 week, and 7% > 1 week. Multivariable logistic regression analysis showed that time to PT session (OR 1.010, 95% CI 1.005-1.016) and ISS (OR 1.063, 95% CI 1.026-1.102) were independently associated with pulmonary complication.

CONCLUSION: Time to mobility is independently associated with pulmonary complications in patients with spine fractures.

Medienart:

E-Artikel

Erscheinungsjahr:

2024

Erschienen:

2024

Enthalten in:

Zur Gesamtaufnahme - year:2024

Enthalten in:

The American surgeon - (2024) vom: 03. Apr., Seite 31348241241702

Sprache:

Englisch

Beteiligte Personen:

Jackson, Michael L [VerfasserIn]
Thomas, Samuel C [VerfasserIn]
Joyner, Matthew R [VerfasserIn]
Hu, Mengjie [VerfasserIn]
Larry Lee, Yann-Leei [VerfasserIn]
Capasso, Thomas [VerfasserIn]
Polite, Nathan M [VerfasserIn]
Kinnard, Christopher M [VerfasserIn]
Mbaka, Maryann I [VerfasserIn]
Williams, Ashley [VerfasserIn]
Simmons, Jon D [VerfasserIn]
Butts, Charles C [VerfasserIn]

Links:

Volltext

Themen:

Journal Article
Mobility
Pulmonary complication
Spinal fractures
Trauma

Anmerkungen:

Date Revised 03.04.2024

published: Print-Electronic

Citation Status Publisher

doi:

10.1177/00031348241241702

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM370560426