Abstract

This retrospective cohort study established malnutrition’s impact on mortality and neurological recovery of older patients with cervical spinal cord injury (SCI). It included patients aged ≥ 65 years with traumatic cervical SCI treated conservatively or surgically. The Geriatric Nutritional Risk Index was calculated to assess nutritional-related risk. Overall, 789 patients (mean follow-up: 20.1 months) were examined and 47 had major nutritional-related risks on admission. One-year mortality rate, median survival time, neurological recovery, and activities of daily living (ADL) at 1 year post-injury were compared between patients with major nutrition-related risk and matched controls selected using 1:2 propensity score matching to adjust for age, pre-traumatic neurological impairment, and activity. In the Kaplan–Meier analysis, the median survival times were 44.9 and 76.5 months for patients with major nutrition-related risk and matched controls, respectively (p = 0.015). Matched controls had more individuals with a neurological improvement of American Spinal Injury Association Impairment Scale ≥ 1 grade (p = 0.039) and independence in ADL at 1 year post-injury than patients with major nutrition-related risk (p < 0.05). In conclusion, 6% of older patients with cervical SCI had major nutrition-related risks; they showed a significantly higher 1 year mortality rate, shorter survival time, poorer neurological improvement, and lower ADL at 1 year post-injury than matched controls.

Details

Title
Impact of malnutrition on mortality and neurological recovery of older patients with spinal cord injury
Author
Tamai, Koji 1   VIAFID ORCID Logo  ; Terai, Hidetomi 1 ; Nakamura, Hiroaki 1 ; Yokogawa, Noriaki 2 ; Sasagawa, Takeshi 3 ; Nakashima, Hiroaki 4 ; Segi, Naoki 4 ; Ito, Sadayuki 4 ; Funayama, Toru 5 ; Eto, Fumihiko 6 ; Yamaji, Akihiro 7 ; Watanabe, Kota 8 ; Yamane, Junichi 9 ; Takeda, Kazuki 10 ; Furuya, Takeo 11 ; Yunde, Atsushi 11 ; Nakajima, Hideaki 12 ; Yamada, Tomohiro 13 ; Hasegawa, Tomohiko 14 ; Terashima, Yoshinori 15 ; Hirota, Ryosuke 16 ; Suzuki, Hidenori 17 ; Imajo, Yasuaki 17 ; Ikegami, Shota 18 ; Uehara, Masashi 18 ; Tonomura, Hitoshi 19 ; Sakata, Munehiro 20 ; Hashimoto, Ko 21 ; Onoda, Yoshito 21 ; Kawaguchi, Kenichi 22 ; Haruta, Yohei 22 ; Suzuki, Nobuyuki 23 ; Kato, Kenji 23 ; Uei, Hiroshi 24 ; Sawada, Hirokatsu 25 ; Nakanishi, Kazuo 26 ; Misaki, Kosuke 26 ; Kuroda, Akiyoshi 27 ; Inoue, Gen 27 ; Kakutani, Kenichiro 28 ; Kakiuchi, Yuji 28 ; Kiyasu, Katsuhito 29 ; Tominaga, Hiroyuki 30 ; Tokumoto, Hiroto 30 ; Iizuka, Yoichi 31 ; Takasawa, Eiji 31 ; Akeda, Koji 32 ; Takegami, Norihiko 32 ; Funao, Haruki 33 ; Oshima, Yasushi 34 ; Kaito, Takashi 35 ; Sakai, Daisuke 36 ; Yoshii, Toshitaka 37 ; Ohba, Tetsuro 38 ; Otsuki, Bungo 39 ; Seki, Shoji 40 ; Miyazaki, Masashi 41 ; Ishihara, Masayuki 42 ; Okada, Seiji 35 ; Imagama, Shiro 4 ; Kato, Satoshi 2 

1  Osaka Metropolitan University Graduate School of Medicine, Department of Orthopaedic Surgery, Osaka, Japan 
2  Kanazawa University, Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa, Japan (GRID:grid.9707.9) (ISNI:0000 0001 2308 3329) 
3  Kanazawa University, Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa, Japan (GRID:grid.9707.9) (ISNI:0000 0001 2308 3329); Toyama Prefectural Central Hospital, Department of Orthopaedic Surgery, Toyama, Japan (GRID:grid.417235.6) (ISNI:0000 0001 0498 6004) 
4  Nagoya University Graduate School of Medicine, Department of Orthopedic Surgery, Nagoya, Japan (GRID:grid.27476.30) (ISNI:0000 0001 0943 978X) 
5  University of Tsukuba, Department of Orthopaedic Surgery, Faculty of Medicine, Tsukuba, Japan (GRID:grid.20515.33) (ISNI:0000 0001 2369 4728) 
6  University of Tsukuba, Department of Orthopaedic Surgery, Graduate School of Comprehensive Human Sciences, Tsukuba, Japan (GRID:grid.20515.33) (ISNI:0000 0001 2369 4728) 
7  Ibaraki Seinan Medical Center Hospital, Department of Orthopaedic Surgery, Ibaraki, Japan (GRID:grid.20515.33) 
8  Keio University School of Medicine, Department of Orthopaedic Surgery, Tokyo, Japan (GRID:grid.26091.3c) (ISNI:0000 0004 1936 9959) 
9  Keio University School of Medicine, Department of Orthopaedic Surgery, Tokyo, Japan (GRID:grid.26091.3c) (ISNI:0000 0004 1936 9959); National Hospital Organization Murayama Medical Center, Department of Orthopaedic Surgery, Tokyo, Japan (GRID:grid.415635.0) 
10  Keio University School of Medicine, Department of Orthopaedic Surgery, Tokyo, Japan (GRID:grid.26091.3c) (ISNI:0000 0004 1936 9959); Japanese Red Cross Shizuoka Hospital, Department of Orthopaedic Surgery, Shizuoka, Japan (GRID:grid.410790.b) (ISNI:0000 0004 0604 5883) 
11  Chiba University, Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba, Japan (GRID:grid.136304.3) (ISNI:0000 0004 0370 1101) 
12  University of Fukui, Department of Orthopaedics and Rehabilitation Medicine, Faculty of Medical Sciences, Fukui, Japan (GRID:grid.163577.1) (ISNI:0000 0001 0692 8246) 
13  Hamamatsu University School of Medicine, Department of Orthopaedic Surgery, Hamamatsu, Japan (GRID:grid.505613.4) (ISNI:0000 0000 8937 6696); Nagoya Kyoritsu Hospital, Department of Orthopaedic Surgery, Nagoya-shi, Japan (GRID:grid.416423.6) (ISNI:0000 0004 5936 3164) 
14  Hamamatsu University School of Medicine, Department of Orthopaedic Surgery, Hamamatsu, Japan (GRID:grid.505613.4) (ISNI:0000 0000 8937 6696) 
15  Sapporo Medical University, Department of Orthopaedic Surgery, Sapporo, Japan (GRID:grid.263171.0) (ISNI:0000 0001 0691 0855); Matsuda Orthopedic Memorial Hospital, Department of Orthopaedic Surgery, Sapporo, Japan (GRID:grid.263171.0) 
16  Sapporo Medical University, Department of Orthopaedic Surgery, Sapporo, Japan (GRID:grid.263171.0) (ISNI:0000 0001 0691 0855) 
17  Yamaguchi University Graduate School of Medicine, Department of Orthopaedic Surgery, Ube, Japan (GRID:grid.268397.1) (ISNI:0000 0001 0660 7960) 
18  Shinshu University School of Medicine, Department of Orthopaedic Surgery, Matsumoto, Japan (GRID:grid.263518.b) (ISNI:0000 0001 1507 4692) 
19  Kyoto Prefectural University of Medicine, Department of Orthopaedics, Graduate School of Medical Science, Kyoto, Japan (GRID:grid.272458.e) (ISNI:0000 0001 0667 4960) 
20  Kyoto Prefectural University of Medicine, Department of Orthopaedics, Graduate School of Medical Science, Kyoto, Japan (GRID:grid.272458.e) (ISNI:0000 0001 0667 4960); Saiseikai Shiga Hospital, Department of Orthopaedics, Ritto, Japan (GRID:grid.416625.2) (ISNI:0000 0000 8488 6734) 
21  Tohoku University Graduate School of Medicine, Department of Orthopaedic Surgery, Sendai, Japan (GRID:grid.69566.3a) (ISNI:0000 0001 2248 6943) 
22  Kyushu University, Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Fukuoka, Japan (GRID:grid.177174.3) (ISNI:0000 0001 2242 4849) 
23  Nagoya City University Graduate School of Medical Sciences, Department of Orthopaedic Surgery, Nagoya, Japan (GRID:grid.260433.0) (ISNI:0000 0001 0728 1069) 
24  Nihon University Hospital, Department of Orthopaedic Surgery, Tokyo, Japan (GRID:grid.412178.9) (ISNI:0000 0004 0620 9665); Nihon University School of Medicine, Department of Orthopaedic Surgery, Tokyo, Japan (GRID:grid.260969.2) (ISNI:0000 0001 2149 8846) 
25  Nihon University School of Medicine, Department of Orthopaedic Surgery, Tokyo, Japan (GRID:grid.260969.2) (ISNI:0000 0001 2149 8846) 
26  Kawasaki Medical School, Department of Orthopedics, Traumatology and Spine Surgery, Kurashiki, Japan (GRID:grid.415086.e) (ISNI:0000 0001 1014 2000) 
27  Kitasato University School of Medicine, Department of Orthopaedic Surgery, Sagamihara, Japan (GRID:grid.410786.c) (ISNI:0000 0000 9206 2938) 
28  Kobe University Graduate School of Medicine, Department of Orthopaedic Surgery, Kobe, Japan (GRID:grid.31432.37) (ISNI:0000 0001 1092 3077) 
29  Kochi University, Department of Orthopaedic Surgery, Kochi Medical School, Nankoku, Japan (GRID:grid.278276.e) (ISNI:0000 0001 0659 9825) 
30  Kagoshima University, Department of Orthopaedic Surgery, Graduate School of Medical and Dental Sciences, Kagoshima, Japan (GRID:grid.258333.c) (ISNI:0000 0001 1167 1801) 
31  Gunma University Graduate School of Medicine, Department of Orthopaedic Surgery, Maebashi, Japan (GRID:grid.256642.1) (ISNI:0000 0000 9269 4097) 
32  Mie University Graduate School of Medicine, Department of Orthopaedic Surgery, Tsu, Japan (GRID:grid.260026.0) (ISNI:0000 0004 0372 555X) 
33  International University of Health and Welfare, Department of Orthopaedic Surgery, School of Medicine, Narita, Japan (GRID:grid.411731.1) (ISNI:0000 0004 0531 3030); International University of Health and Welfare Narita Hospital, Department of Orthopaedic Surgery, Narita, Japan (GRID:grid.411731.1) (ISNI:0000 0004 0531 3030); International University of Health and Welfare Mita Hospital, Department of Orthopaedic Surgery and Spine and Spinal Cord Center, Tokyo, Japan (GRID:grid.415958.4) (ISNI:0000 0004 1771 6769) 
34  The University of Tokyo Hospital, Department of Orthopaedic Surgery, Tokyo, Japan (GRID:grid.412708.8) (ISNI:0000 0004 1764 7572) 
35  Osaka University Graduate School of Medicine, Department of Orthopaedic Surgery, Suita, Japan (GRID:grid.136593.b) (ISNI:0000 0004 0373 3971) 
36  Tokai University School of Medicine, Department of Orthopedics Surgery, Surgical Science, Isehara, Japan (GRID:grid.265061.6) (ISNI:0000 0001 1516 6626) 
37  Tokyo Medical and Dental University, Department of Orthopaedic Surgery, Tokyo, Japan (GRID:grid.265073.5) (ISNI:0000 0001 1014 9130) 
38  University of Yamanashi, Department of Orthopaedic Surgery, Chuo, Japan (GRID:grid.267500.6) (ISNI:0000 0001 0291 3581) 
39  Kyoto University, Department of Orthopaedic Surgery, Graduate School of Medicine, Kyoto, Japan (GRID:grid.258799.8) (ISNI:0000 0004 0372 2033) 
40  University of Toyama, Department of Orthopaedic Surgery, Faculty of Medicine, Toyama, Japan (GRID:grid.267346.2) (ISNI:0000 0001 2171 836X) 
41  Oita University, Department of Orthopaedic Surgery, Faculty of Medicine, Yufu-shi, Japan (GRID:grid.412334.3) (ISNI:0000 0001 0665 3553) 
42  Kansai Medical University Hospital, Department of Orthopaedic Surgery, Hirakata, Japan (GRID:grid.410783.9) (ISNI:0000 0001 2172 5041) 
Pages
5853
Publication year
2024
Publication date
2024
Publisher
Nature Publishing Group
e-ISSN
20452322
Source type
Scholarly Journal
Language of publication
English
DOI
https://doi.org/10.1038/s41598-024-56527-y
ProQuest document ID
2954651311
Copyright
© The Author(s) 2024. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.