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Jackson ML, Thomas SC, Joyner MR, Hu M, Larry Lee YL, Capasso T, Polite NM, Kinnard CM, Mbaka MI, Williams A, Simmons JD, Butts CC. Time to Mobility Is Associated With Pulmonary Complications in Patients With Spine Fractures. Am Surg 2024:31348241241702. [PMID: 38566605 DOI: 10.1177/00031348241241702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Abstract
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.
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Affiliation(s)
- Michael L Jackson
- General Surgery Residency Program, University of South Alabama, Mobile, AL, USA
| | - Samuel C Thomas
- General Surgery Residency Program, Brookwood Baptist Health, Birmingham, AL, USA
| | - Matthew R Joyner
- General Surgery Residency Program, University of Tennessee Knoxville, Knoxville, TN, USA
| | - Mengjie Hu
- Anesthesiology Residency Program, Wake Forest University, Winston-Salem, NC, USA
| | | | - Thomas Capasso
- Department of Surgery, University of South Alabama, Mobile, AL, USA
| | - Nathan M Polite
- Department of Surgery, University of South Alabama, Mobile, AL, USA
| | | | - Maryann I Mbaka
- Department of Surgery, University of South Alabama, Mobile, AL, USA
| | - Ashley Williams
- Department of Surgery, University of South Alabama, Mobile, AL, USA
| | - Jon D Simmons
- Department of Surgery, University of South Alabama, Mobile, AL, USA
| | - Charles C Butts
- Department of Surgery, University of South Alabama, Mobile, AL, USA
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