Clinical risk factors associated with the need for tracheostomy in traumatic cervical and high thoracic spinal cord injury

Am J Surg. 2025 Jan:239:116033. doi: 10.1016/j.amjsurg.2024.116033. Epub 2024 Oct 22.

Abstract

Background: Our objective was to assess the association of completeness and level of spinal cord injury (SCI) with the need for tracheostomy and identify additional risk factors predictive of tracheostomy.

Methods: This was a retrospective review of patients with SCI between January 2017 and December 2022.

Results: Patients with complete SCI were roughly thirty-three times more likely to have a tracheostomy when compared to incomplete injury (82 ​% vs 12 ​%, p ​< ​0.001, OR ​= ​32.9). The rate of tracheostomy did not differ between spinal cord levels for complete (p ​= ​0.68) or incomplete (p ​= ​0.08) injuries. Penetrating injury, low GCS, high ISS, and polytrauma were associated with tracheostomy need in incomplete SCI.

Conclusion: Complete injury was statistically significantly associated with the need for tracheostomy while level of injury failed to reach significance. Patients with incomplete SCI that have certain clinical risk factors should be considered for early tracheostomy.

Keywords: Complete injury; Spinal cord injury; Tracheostomy.

MeSH terms

  • Adult
  • Aged
  • Cervical Vertebrae / injuries
  • Female
  • Humans
  • Male
  • Middle Aged
  • Retrospective Studies
  • Risk Factors
  • Spinal Cord Injuries* / complications
  • Thoracic Vertebrae / injuries
  • Thoracic Vertebrae / surgery
  • Tracheostomy*