Scientific Reports (Mar 2024)
Impact of malnutrition on mortality and neurological recovery of older patients with spinal cord injury
- Koji Tamai,
- Hidetomi Terai,
- Hiroaki Nakamura,
- Noriaki Yokogawa,
- Takeshi Sasagawa,
- Hiroaki Nakashima,
- Naoki Segi,
- Sadayuki Ito,
- Toru Funayama,
- Fumihiko Eto,
- Akihiro Yamaji,
- Kota Watanabe,
- Junichi Yamane,
- Kazuki Takeda,
- Takeo Furuya,
- Atsushi Yunde,
- Hideaki Nakajima,
- Tomohiro Yamada,
- Tomohiko Hasegawa,
- Yoshinori Terashima,
- Ryosuke Hirota,
- Hidenori Suzuki,
- Yasuaki Imajo,
- Shota Ikegami,
- Masashi Uehara,
- Hitoshi Tonomura,
- Munehiro Sakata,
- Ko Hashimoto,
- Yoshito Onoda,
- Kenichi Kawaguchi,
- Yohei Haruta,
- Nobuyuki Suzuki,
- Kenji Kato,
- Hiroshi Uei,
- Hirokatsu Sawada,
- Kazuo Nakanishi,
- Kosuke Misaki,
- Akiyoshi Kuroda,
- Gen Inoue,
- Kenichiro Kakutani,
- Yuji Kakiuchi,
- Katsuhito Kiyasu,
- Hiroyuki Tominaga,
- Hiroto Tokumoto,
- Yoichi Iizuka,
- Eiji Takasawa,
- Koji Akeda,
- Norihiko Takegami,
- Haruki Funao,
- Yasushi Oshima,
- Takashi Kaito,
- Daisuke Sakai,
- Toshitaka Yoshii,
- Tetsuro Ohba,
- Bungo Otsuki,
- Shoji Seki,
- Masashi Miyazaki,
- Masayuki Ishihara,
- Seiji Okada,
- Shiro Imagama,
- Satoshi Kato
Affiliations
- Koji Tamai
- Department of Orthopaedic Surgery, Osaka Metropolitan University Graduate School of Medicine
- Hidetomi Terai
- Department of Orthopaedic Surgery, Osaka Metropolitan University Graduate School of Medicine
- Hiroaki Nakamura
- Department of Orthopaedic Surgery, Osaka Metropolitan University Graduate School of Medicine
- Noriaki Yokogawa
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa University
- Takeshi Sasagawa
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa University
- Hiroaki Nakashima
- Department of Orthopedic Surgery, Nagoya University Graduate School of Medicine
- Naoki Segi
- Department of Orthopedic Surgery, Nagoya University Graduate School of Medicine
- Sadayuki Ito
- Department of Orthopedic Surgery, Nagoya University Graduate School of Medicine
- Toru Funayama
- Department of Orthopaedic Surgery, Faculty of Medicine, University of Tsukuba
- Fumihiko Eto
- Department of Orthopaedic Surgery, Graduate School of Comprehensive Human Sciences, University of Tsukuba
- Akihiro Yamaji
- Department of Orthopaedic Surgery, Ibaraki Seinan Medical Center Hospital
- Kota Watanabe
- Department of Orthopaedic Surgery, Keio University School of Medicine
- Junichi Yamane
- Department of Orthopaedic Surgery, Keio University School of Medicine
- Kazuki Takeda
- Department of Orthopaedic Surgery, Keio University School of Medicine
- Takeo Furuya
- Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University
- Atsushi Yunde
- Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University
- Hideaki Nakajima
- Department of Orthopaedics and Rehabilitation Medicine, Faculty of Medical Sciences, University of Fukui
- Tomohiro Yamada
- Department of Orthopaedic Surgery, Hamamatsu University School of Medicine
- Tomohiko Hasegawa
- Department of Orthopaedic Surgery, Hamamatsu University School of Medicine
- Yoshinori Terashima
- Department of Orthopaedic Surgery, Sapporo Medical University
- Ryosuke Hirota
- Department of Orthopaedic Surgery, Sapporo Medical University
- Hidenori Suzuki
- Department of Orthopaedic Surgery, Yamaguchi University Graduate School of Medicine
- Yasuaki Imajo
- Department of Orthopaedic Surgery, Yamaguchi University Graduate School of Medicine
- Shota Ikegami
- Department of Orthopaedic Surgery, Shinshu University School of Medicine
- Masashi Uehara
- Department of Orthopaedic Surgery, Shinshu University School of Medicine
- Hitoshi Tonomura
- Department of Orthopaedics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine
- Munehiro Sakata
- Department of Orthopaedics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine
- Ko Hashimoto
- Department of Orthopaedic Surgery, Tohoku University Graduate School of Medicine
- Yoshito Onoda
- Department of Orthopaedic Surgery, Tohoku University Graduate School of Medicine
- Kenichi Kawaguchi
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University
- Yohei Haruta
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University
- Nobuyuki Suzuki
- Department of Orthopaedic Surgery, Nagoya City University Graduate School of Medical Sciences
- Kenji Kato
- Department of Orthopaedic Surgery, Nagoya City University Graduate School of Medical Sciences
- Hiroshi Uei
- Department of Orthopaedic Surgery, Nihon University Hospital
- Hirokatsu Sawada
- Department of Orthopaedic Surgery, Nihon University School of Medicine
- Kazuo Nakanishi
- Department of Orthopedics, Traumatology and Spine Surgery, Kawasaki Medical School
- Kosuke Misaki
- Department of Orthopedics, Traumatology and Spine Surgery, Kawasaki Medical School
- Akiyoshi Kuroda
- Department of Orthopaedic Surgery, Kitasato University School of Medicine
- Gen Inoue
- Department of Orthopaedic Surgery, Kitasato University School of Medicine
- Kenichiro Kakutani
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine
- Yuji Kakiuchi
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine
- Katsuhito Kiyasu
- Department of Orthopaedic Surgery, Kochi Medical School, Kochi University
- Hiroyuki Tominaga
- Department of Orthopaedic Surgery, Graduate School of Medical and Dental Sciences, Kagoshima University
- Hiroto Tokumoto
- Department of Orthopaedic Surgery, Graduate School of Medical and Dental Sciences, Kagoshima University
- Yoichi Iizuka
- Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine
- Eiji Takasawa
- Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine
- Koji Akeda
- Department of Orthopaedic Surgery, Mie University Graduate School of Medicine
- Norihiko Takegami
- Department of Orthopaedic Surgery, Mie University Graduate School of Medicine
- Haruki Funao
- Department of Orthopaedic Surgery, School of Medicine, International University of Health and Welfare
- Yasushi Oshima
- Department of Orthopaedic Surgery, The University of Tokyo Hospital
- Takashi Kaito
- Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine
- Daisuke Sakai
- Department of Orthopedics Surgery, Surgical Science, Tokai University School of Medicine
- Toshitaka Yoshii
- Department of Orthopaedic Surgery, Tokyo Medical and Dental University
- Tetsuro Ohba
- Department of Orthopaedic Surgery, University of Yamanashi
- Bungo Otsuki
- Department of Orthopaedic Surgery, Graduate School of Medicine, Kyoto University
- Shoji Seki
- Department of Orthopaedic Surgery, Faculty of Medicine, University of Toyama
- Masashi Miyazaki
- Department of Orthopaedic Surgery, Faculty of Medicine, Oita University
- Masayuki Ishihara
- Department of Orthopaedic Surgery, Kansai Medical University Hospital
- Seiji Okada
- Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine
- Shiro Imagama
- Department of Orthopedic Surgery, Nagoya University Graduate School of Medicine
- Satoshi Kato
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa University
- DOI
- https://doi.org/10.1038/s41598-024-56527-y
- Journal volume & issue
-
Vol. 14,
no. 1
pp. 1 – 9
Abstract
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.
