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

IF 1 4区医学 Q3 SURGERY

American Surgeon 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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引用次数: 0

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

American Surgeon 医学-外科

CiteScore

1.40

自引率

0.00%

发文量

623

期刊介绍： The American Surgeon is a monthly peer-reviewed publication published by the Southeastern Surgical Congress. Its area of concentration is clinical general surgery, as defined by the content areas of the American Board of Surgery: alimentary tract (including bariatric surgery), abdomen and its contents, breast, skin and soft tissue, endocrine system, solid organ transplantation, pediatric surgery, surgical critical care, surgical oncology (including head and neck surgery), trauma and emergency surgery, and vascular surgery.