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Abstract
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OBJECTIVES: To characterize patients with an acute traumatic spinal cord injury (ATSCI) above T6 who were admitted to the Intensive Care Unit (ICU) for ≥30 days, as well as their one-year mortality, in comparison with patients admitted for <30 days.
METHODS: A retrospective, observational study was performed on 211 patients with an ATSCI above T6 who were admitted to an ICU of a Spanish hospital between 1998-2017. A multivariate logistic regression analysis was performed to determine the relationship between an ICU stay ≥30 days and post-ICU discharge mortality.
RESULTS: A total of 29.4% of the patients were admitted to the ICU for ≥ 30 days, accounting for 53.4% of the total days of ICU stays generated by all patients. An ICU stay ≥30 days was not identified as an independent risk factor for mortality (one-year survival: 88.5% vs. 88.1%) (adjusted hazard ratio [HR]=0.80; p=0.699). Variables identified as predictors of one-year post-ICU discharge mortality were severity at admission according to the Acute Physiology and Chronic Health Evaluation (APACHE) II scale (HR=1.18) and the ASIA motor score (HR=0.97). Among those patients who required invasive mechanical ventilation (IMV), a longer duration of the respiratory support was associated with increased mortality (HR=1.01).
CONCLUSIONS: Three out of ten patients with an ATSCI above T6 require prolonged stays in the ICU. The variables found to be associated with one-year post-ICU discharge mortality in these patients were the ASIA motor score, severity, and greater duration of the IMV, but not an ICU stay ≥30 days.
Language: en |