title: Complete cervical spinal cord injury above C6 predicts the need for tracheostomy.
abstract: BACKGROUND
  Failed extubation and delayed tracheostomy contribute to poor outcomes in patients with a traumatic spinal cord injury (SCI). We determined if the level and completeness of SCI predict the need for tracheostomy.
  
  
  METHODS
  Data from 256 patients with SCI between C1 and T3 with or without tracheostomy were retrospectively analyzed. Logistic regression identified predictors for tracheostomy. Data are presented as raw percentage or odds ratio (OR) with 95% confidence interval. P < .05 indicates significance.
  
  
  RESULTS
  Complete spinal cord injuries were common in patients requiring tracheostomy (55% vs 18%, P < .05), and predicted the need for tracheostomy (OR: 6.4 (3.1 to 13.5), P < .05). An injury above C6 predicted the need for tracheostomy in patients with complete injury (OR: 3.7 (1 to 11.9), P < .05), but not incomplete injury (OR: .7 (.3 to 1.9); P = .53).
  
  
  CONCLUSIONS
  Tracheostomy is unlikely in patients with incomplete SCI, regardless of the level of injury. Patients with complete SCI above C6 are likely to require tracheostomy.
authors.affiliation: Trauma Research Institute of Oregon, Division of Trauma, Critical Care and Acute Care Surgery, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd, Portland, OR 97239, USA. Electronic address: houghtob@ohsu.edu.
authors.forename: Belinda H
authors.initials: BH
authors.lastname: McCully
authors.affiliation: Trauma Research Institute of Oregon, Division of Trauma, Critical Care and Acute Care Surgery, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd, Portland, OR 97239, USA.
authors.forename: Loic
authors.initials: L
authors.lastname: Fabricant
authors.affiliation: Trauma Research Institute of Oregon, Division of Trauma, Critical Care and Acute Care Surgery, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd, Portland, OR 97239, USA.
authors.forename: Travis
authors.initials: T
authors.lastname: Geraci
authors.affiliation: Trauma Research Institute of Oregon, Division of Trauma, Critical Care and Acute Care Surgery, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd, Portland, OR 97239, USA.
authors.forename: Alissa
authors.initials: A
authors.lastname: Greenbaum
authors.affiliation: Trauma Research Institute of Oregon, Division of Trauma, Critical Care and Acute Care Surgery, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd, Portland, OR 97239, USA.
authors.forename: Martin A
authors.initials: MA
authors.lastname: Schreiber
authors.affiliation: Trauma Research Institute of Oregon, Division of Trauma, Critical Care and Acute Care Surgery, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd, Portland, OR 97239, USA; Michael E. DeBakey Department of Surgery, Baylor Medical College, Michael E. DeBakey VA Medical Center, Houston, TX, USA.
authors.forename: Stephanie D
authors.initials: SD
authors.lastname: Gordy
mesh_terms: D000328:Adult; D002574:Cervical Vertebrae / Q000293:injuries; D003661:Decision Support Techniques; D005260:Female; D015600:Glasgow Coma Scale; D006801:Humans; D015601:Injury Severity Score; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D012189:Retrospective Studies; D012307:Risk Factors; D013119:Spinal Cord Injuries / Q000601:surgery*; D014139:Tracheostomy
keywords: Cervical spinal cord; Complete injury; Tracheostomy