Postoperative survival analysis of 276 cases of severe cervical spinal cord injury with tetraplegia
Objective This study is aimed to analyze the cumulative survival rate and identify risk factors associated with mortality in a cohort of 276 patients with tetraplegia resulting from cervical spinal cord injury(classified as ASIA grades A or B)fol-lowing surgical intervention and to identify significant covariates that impact survival time and overall outcomes.Methods A retro-spective analysis was conducted on the clinical data of patients with traumatic cervical spinal cord injury resulting in tetraplegia(ASIA grades A and B)who were hospitalized and underwent surgical treatment at our hospital from January 1,2010 to June 30,2022.The survival rates of these patients were estimated using the Kaplan-Meier method.The log-rank test was utilized for the comparison of sur-vival rates between different subgroups based on single grouping variables.Furthermore,univariate and multivariate survival analysis were performed using the Cox proportional hazards regression model.Results A total of 276 patients were included in the study based on the inclusion and exclusion criteria.The 1-year,5-year,and 10-year survival rates were 79.92％,71.77％,and 65.07％,re-spectively.The mean survival time for deceased patients was 560.88±94.23 days,with a median survival time of 198 days(QI,25;Q3,688).Univariate Cox analysis revealed that advanced age(＞50 years),presence of underlying conditions such as hypertension or dia-betes,ICU stay＞72 hours,pulmonary infection,respiratory failure,and gastrointestinal bleeding were risk factors for patient mortality.Within the surgical approach variable,the survival rate was signifi-cantly higher for anterior surgery compared to posterior surgery(P=0.017).Multivariate Cox proportional hazards regression model analysis showed that advanced age(＞50 years),presence of underlying conditions such as hypertension or diabetes,pulmonary infec-tion,and respiratory failure were independent risk factors for patient survival.Conclusion High attention should be paid to elderly CSCI patients with tetraplegia,and special caution should be exercised in the management of postoperative complications such as early pulmonary infection and respiratory failure in clinic.Basic diseases,such as hypertension and diabetes,may affect the recovery process and prognosis of patients.
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