Predicting respiratory infection one year after inpatient rehabilitation with pulmonary function measured at discharge in persons with spinal cord injury.
OBJECTIVE
To determine whether pulmonary function at discharge from inpatient rehabilitation can predict respiratory infection in spinal cord injury in the first year after discharge, and to determine which pulmonary function parameter predicts best.


METHODS
Multicentre prospective cohort study.


METHODS
A total of 140 persons with spinal cord injury.


METHODS
Pulmonary function was tested at discharge from inpatient rehabilitation. Pulmonary function parameters (expressed in absolute and percentage predicted values) were: forced vital capacity, forced expiratory volume in 1 sec, and peak expiratory flow. Respiratory infection was determined one year after discharge by a physician. Differences between the respiratory infection and non-respiratory infection groups were tested; and receiver operating characteristic curves were used to determine how accurately pulmonary function parameters could predict respiratory infection.


RESULTS
Of the 140 participants, 14 (10%) experienced respiratory infection in the first year after discharge. All pulmonary function parameters were significantly lower in persons who experienced respiratory infection than in those who did not. All pulmonary function parameters were almost equally accurate in predicting respiratory infection; only percentage predicted forced vital capacity was less accurate.


CONCLUSIONS
Pulmonary function at discharge from inpatient rehabilitation can be used as a predictor of respiratory infection in the first year after discharge in spinal cord injury. No single pulmonary function parameter was a clearly superior predictor of respiratory infection.
Postma
Karin
K
Department of Rehabilitation Medicine, Erasmus MC, University Medical Center Rotterdam, The Netherlands. k.postma@rijndam.nl
Bussmann
Johannes B
JB
Haisma
Janneke A
JA
van der Woude
Lucas H
LH
Bergen
Michael P
MP
Stam
Henk J
HJ
D000328:Adult; D015331:Cohort Studies; D005260:Female; D005541:Forced Expiratory Volume; D006801:Humans; D008168:Lung / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D010351:Patient Discharge; D010366:Peak Expiratory Flow Rate; D011379:Prognosis; D011446:Prospective Studies; D012141:Respiratory Tract Infections / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D012307:Risk Factors; D012680:Sensitivity and Specificity; D013119:Spinal Cord Injuries / Q000150:complications* / Q000503:physiopathology / Q000534:rehabilitation; D013997:Time Factors