Impact of Cardiac Pacemaker Implantation in Patients With Acute Traumatic Cervical Spinal Cord Injury.

IF 16.4 1区化学 Q1 CHEMISTRY, MULTIDISCIPLINARY Accounts of Chemical Research Pub Date : 2024-10-01 Epub Date: 2024-04-30 DOI:10.1177/00031348241250041

Maru Kim, Matthew Firek, Bruno Cammarota Coimbra, Timothy Allison-Aipa, Bishoy Zakhary, Raul Coimbra

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Abstract

Background: Cardiac pacemaker implantation may be indicated in patients with refractory bradycardia following a cervical spinal cord injury (CSCI). However, evidence about the impact of this procedure on outcomes is lacking. We planned a study to assess whether the implantation of a pacemaker would decrease mortality and hospital resource utilization in patients with CSCI.

Methods: Adult patients with CSCI in the Trauma Quality Improvement Program (TQIP) database between 2016 and 2019 were retrospectively analyzed. Patients were divided into "pacemaker" and "non-pacemaker" groups, and their baseline characteristics and clinical outcomes were analyzed.

Results: A total of 6774 cases were analyzed. The pacemaker group showed higher in-hospital rates of cardiac arrest, myocardial infarction, and longer duration of mechanical ventilation and ICU stay than the non-pacemaker group. Nevertheless, pacemaker placement was associated with a significant decrease in mortality (4.2% vs 26.0%, P < .01).

Conclusions: Patients with CSCI requiring a pacemaker placement had better survival than those treated without a pacemaker. Pacemaker implantation should be highly considered in patients who develop refractory bradycardia after CSCI.

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急性外伤性颈脊髓损伤患者植入心脏起搏器的影响

背景：颈脊髓损伤（CSCI）后出现难治性心动过缓的患者可能需要植入心脏起搏器。然而，有关该手术对治疗效果的影响还缺乏证据。我们计划进行一项研究，以评估植入起搏器是否会降低 CSCI 患者的死亡率和医院资源利用率：我们对 2016 年至 2019 年期间创伤质量改进计划（TQIP）数据库中的 CSCI 成人患者进行了回顾性分析。将患者分为 "起搏器 "组和 "非起搏器 "组，分析其基线特征和临床结局：结果：共分析了 6774 例患者。与未安装起搏器组相比，安装起搏器组患者的院内心脏骤停、心肌梗死发生率更高，机械通气和重症监护室住院时间更长。尽管如此，安装起搏器后死亡率显著下降（4.2% vs 26.0%，P < .01）：结论：需要植入起搏器的CSCI患者的生存率高于未植入起搏器的患者。CSCI后出现难治性心动过缓的患者应高度考虑植入起搏器。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Accounts of Chemical Research 化学-化学综合

CiteScore

31.40

自引率

1.10%

发文量

312

审稿时长

2 months

期刊介绍： Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance. Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.