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A Contusive Model of Unilateral Cervical Spinal Cord Injury Using the Infinite Horizon Impactor
Published on: July 24, 2012
Impact of Cardiac Pacemaker Implantation in Patients With Acute Traumatic Cervical Spinal Cord Injury
Maru Kim1,2, Matthew Firek1, Bruno Cammarota Coimbra1,3
1Comparative Effectiveness and Clinical Outcomes Research Center, Riverside University Health System, Moreno Valley, CA, USA.
Insights
Pacemaker implantation in cervical spinal cord injury (CSCI) patients with bradycardia significantly reduces mortality. Despite higher initial complication risks, pacemakers improve survival rates for these critically ill individuals.
Area of Science:
- Cardiology
- Neurosurgery
- Trauma Surgery
Background:
- Refractory bradycardia is a complication of cervical spinal cord injury (CSCI).
- The impact of cardiac pacemaker implantation on outcomes in CSCI patients is not well-established.
- Evidence is needed to evaluate pacemaker use in CSCI patients with bradycardia.
Purpose of the Study:
- To assess the impact of pacemaker implantation on mortality in CSCI patients.
- To evaluate the effect of pacemakers on hospital resource utilization in CSCI patients.
Main Methods:
- Retrospective analysis of adult CSCI patients from the 2016-2019 Trauma Quality Improvement Program (TQIP) database.
- Comparison of outcomes between patients who received a pacemaker and those who did not.
Main Results:
- A total of 6774 CSCI cases were analyzed.
- The pacemaker group had higher rates of in-hospital cardiac arrest, myocardial infarction, and longer mechanical ventilation and ICU stays.
- Pacemaker placement was associated with a significant reduction in mortality (4.2% vs 26.0%, P < .01).
Conclusions:
- CSCI patients requiring pacemakers demonstrated improved survival compared to those without.
- Pacemaker implantation is recommended for CSCI patients who develop refractory bradycardia.
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.
