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Peer-reviewedCC BY-NC-ND 4.0In Vivo

Incidence and Predictors of Systemic Complications in Hospitalized Patients With Cervical Traumatic Spinal Cord Injury

  • SHIH-HSIANG KING1,2,3
  • MENG-HSUAN HSIEH3
  • TING-LIN YEN4,5
  • CHENG-TA HSIEH3,6,7
7 affiliations
  1. 1Department of Neurosurgery, Hsinchu Cathay General Hospital, Hsinchu, Taiwan, R.O.C.
  2. 2Center for Liberal Education, Minghsin University of Science and Technology, Hsinchu, Taiwan, R.O.C.
  3. 3Division of Neurosurgery, Department of Surgery, Cathay General Hospital, Taipei, Taiwan, R.O.C.
  4. 4Department of Medical Research, Cathay General Hospital, Taipei, Taiwan, R.O.C.
  5. 5Department of Pharmacology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan, R.O.C.
  6. 6School of Medicine, National Tsing Hua University, Hsinchu, Taiwan, R.O.C.
  7. 7Department of Medicine, School of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan, R.O.C.
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Abstract

Background/Aim: Traumatic spinal cord injury (tSCI) is accompanied by systemic physiological vulnerability due to autonomic dysregulation and impaired organ function. Although acute systemic complications are common and may compromise early outcomes, their independent predictors remain unclear, particularly in Asian health-care settings, in which prolonged acute hospitalization is common. This study aimed to determine the incidence and independent predictors of systemic complications among surgically treated patients with cervical tSCI.

Patients and Methods: This retrospective study included adults with acute cervical tSCI who underwent surgery at a single tertiary center between 2010 and 2025. Demographic characteristics, injury characteristics, clinical course variables, and in-hospital systemic complications were evaluated. Outcomes assessed included in-hospital mortality and neurological improvement, defined as an increase of ≥1 American Spinal Injury Association grade at discharge. Multivariable logistic regression was performed to identify independent predictors of major complications.

Results: Data on 92 patients were analyzed. Urinary tract infection (UTI; 35.9%), pneumonia (22.8%), and ileus (18.5%) were the most frequent complications. In-hospital mortality rate was 8.7%. Approximately 41.3% of the patients exhibited neurological improvement. Initial American Spinal Injury Association grade was significantly associated with both neurological recovery and mortality. Pneumonia and UTI were strongly associated with in-hospital death. Longer hospital stay was independently associated with UTI and ileus, whereas advanced age and lower body mass index were independently associated with ileus. Longer ventilator exposure was independently associated with respiratory complications.

Conclusion: Systemic complications are common after surgical treatment of cervical tSCI and are closely associated with early mortality. Care-related factors, particularly prolonged hospitalization and ventilator exposure, were associated with systemic complications. These variables may represent markers of a more complicated clinical course rather than direct causal factors and should be interpreted accordingly.

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Cite

BibTeXRIS
BibTeX
@article{king2026incidence,
  title = {{Incidence and Predictors of Systemic Complications in Hospitalized Patients With Cervical Traumatic Spinal Cord Injury}},
  author = {SHIH-HSIANG KING and MENG-HSUAN HSIEH and TING-LIN YEN and CHENG-TA HSIEH},
  journal = {In Vivo},
  year = {2026},
  month = oct,
  doi = {10.21873/invivo.14512},
  url = {https://doi.org/10.21873/invivo.14512},
  note = {CC BY-NC-ND 4.0},
}
RIS
TY  - JOUR
TI  - Incidence and Predictors of Systemic Complications in Hospitalized Patients With Cervical Traumatic Spinal Cord Injury
AU  - SHIH-HSIANG KING
AU  - MENG-HSUAN HSIEH
AU  - TING-LIN YEN
AU  - CHENG-TA HSIEH
PY  - 2026
DA  - 2026/10/29
JO  - In Vivo
DO  - 10.21873/invivo.14512
UR  - https://doi.org/10.21873/invivo.14512
AB  - Background/Aim: Traumatic spinal cord injury (tSCI) is accompanied by systemic physiological vulnerability due to autonomic dysregulation and impaired organ function. Although acute systemic complications are common and may compromise early outcomes, their independent predictors remain unclear, particularly in Asian health-care settings, in which prolonged acute hospitalization is common. This study aimed to determine the incidence and independent predictors of systemic complications among surgically treated patients with cervical tSCI.  Patients and Methods: This retrospective study included adults with acute cervical tSCI who underwent surgery at a single tertiary center between 2010 and 2025. Demographic characteristics, injury characteristics, clinical course variables, and in-hospital systemic complications were evaluated. Outcomes assessed included in-hospital mortality and neurological improvement, defined as an increase of ≥1 American Spinal Injury Association grade at discharge. Multivariable logistic regression was performed to identify independent predictors of major complications.  Results: Data on 92 patients were analyzed. Urinary tract infection (UTI; 35.9%), pneumonia (22.8%), and ileus (18.5%) were the most frequent complications. In-hospital mortality rate was 8.7%. Approximately 41.3% of the patients exhibited neurological improvement. Initial American Spinal Injury Association grade was significantly associated with both neurological recovery and mortality. Pneumonia and UTI were strongly associated with in-hospital death. Longer hospital stay was independently associated with UTI and ileus, whereas advanced age and lower body mass index were independently associated with ileus. Longer ventilator exposure was independently associated with respiratory complications.  Conclusion: Systemic complications are common after surgical treatment of cervical tSCI and are closely associated with early mortality. Care-related factors, particularly prolonged hospitalization and ventilator exposure, were associated with systemic complications. These variables may represent markers of a more complicated clinical course rather than direct causal factors and should be interpreted accordingly.
SN  - 0258-851X
SN  - 1791-7549
ER  -