Systematic Review of Incidence Studies of Pneumonia in Persons with Spinal Cord Injury
Pneumonia continues to complicate the course of spinal cord injury (SCI). Currently, clinicians and policy-makers are faced with only limited numbers of pneumonia incidence in the literature. A systematic review of the literature was undertaken to provide an objective synthesis of the evidence about...
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| Format: | Article |
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MDPI AG
2021-12-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/11/1/211 |
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| author | Anja Maria Raab Gabi Mueller Simone Elsig Simon C. Gandevia Marcel Zwahlen Maria T. E. Hopman Roger Hilfiker |
| author_facet | Anja Maria Raab Gabi Mueller Simone Elsig Simon C. Gandevia Marcel Zwahlen Maria T. E. Hopman Roger Hilfiker |
| author_sort | Anja Maria Raab |
| collection | DOAJ |
| description | Pneumonia continues to complicate the course of spinal cord injury (SCI). Currently, clinicians and policy-makers are faced with only limited numbers of pneumonia incidence in the literature. A systematic review of the literature was undertaken to provide an objective synthesis of the evidence about the incidence of pneumonia in persons with SCI. Incidence was calculated per 100 person-days, and meta-regression was used to evaluate the influence of the clinical setting, the level of injury, the use of mechanical ventilation, the presence of tracheostomy, and dysphagia. For the meta-regression we included 19 studies. The incidence ranged from 0.03 to 7.21 patients with pneumonia per 100 days. The main finding of this review is that we found large heterogeneity in the reporting of the incidence, and we therefore should be cautious with interpreting the results. In the multivariable meta-regression, the incidence rate ratios showed very wide confidence intervals, which does not allow a clear conclusion concerning the risk of pneumonia in the different stages after a SCI. Large longitudinal studies with a standardized reporting on risk factors, pneumonia, and detailed time under observation are needed. Nevertheless, this review showed that pneumonia is still a clinically relevant complication and pneumonia prevention should focus on the ICU setting and patients with complete tetraplegia. |
| first_indexed | 2024-03-10T03:36:16Z |
| format | Article |
| id | doaj.art-fead87effd284aaab2435d53643b68dd |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-10T03:36:16Z |
| publishDate | 2021-12-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-fead87effd284aaab2435d53643b68dd2023-11-23T11:45:24ZengMDPI AGJournal of Clinical Medicine2077-03832021-12-0111121110.3390/jcm11010211Systematic Review of Incidence Studies of Pneumonia in Persons with Spinal Cord InjuryAnja Maria Raab0Gabi Mueller1Simone Elsig2Simon C. Gandevia3Marcel Zwahlen4Maria T. E. Hopman5Roger Hilfiker6Clinical Trial Unit, Swiss Paraplegic Centre, 6207 Nottwil, SwitzerlandClinical Trial Unit, Swiss Paraplegic Centre, 6207 Nottwil, SwitzerlandSchool of Health Sciences Valais, Physiotherapy, University of Applied Sciences and Arts Western Switzer Land Valais, 1950 Sion, SwitzerlandNeuroscience Research Australia, Randwick 2031, AustraliaInstitute of Social and Preventive Medicine, University of Bern, 3012 Bern, SwitzerlandDepartment of Physiology, Radboud University Nijmegen, 6525 Nijmegen, The NetherlandsSchool of Health Sciences Valais, Physiotherapy, University of Applied Sciences and Arts Western Switzer Land Valais, 1950 Sion, SwitzerlandPneumonia continues to complicate the course of spinal cord injury (SCI). Currently, clinicians and policy-makers are faced with only limited numbers of pneumonia incidence in the literature. A systematic review of the literature was undertaken to provide an objective synthesis of the evidence about the incidence of pneumonia in persons with SCI. Incidence was calculated per 100 person-days, and meta-regression was used to evaluate the influence of the clinical setting, the level of injury, the use of mechanical ventilation, the presence of tracheostomy, and dysphagia. For the meta-regression we included 19 studies. The incidence ranged from 0.03 to 7.21 patients with pneumonia per 100 days. The main finding of this review is that we found large heterogeneity in the reporting of the incidence, and we therefore should be cautious with interpreting the results. In the multivariable meta-regression, the incidence rate ratios showed very wide confidence intervals, which does not allow a clear conclusion concerning the risk of pneumonia in the different stages after a SCI. Large longitudinal studies with a standardized reporting on risk factors, pneumonia, and detailed time under observation are needed. Nevertheless, this review showed that pneumonia is still a clinically relevant complication and pneumonia prevention should focus on the ICU setting and patients with complete tetraplegia.https://www.mdpi.com/2077-0383/11/1/211pneumoniaspinal cord injurysystematic reviewincidence |
| spellingShingle | Anja Maria Raab Gabi Mueller Simone Elsig Simon C. Gandevia Marcel Zwahlen Maria T. E. Hopman Roger Hilfiker Systematic Review of Incidence Studies of Pneumonia in Persons with Spinal Cord Injury Journal of Clinical Medicine pneumonia spinal cord injury systematic review incidence |
| title | Systematic Review of Incidence Studies of Pneumonia in Persons with Spinal Cord Injury |
| title_full | Systematic Review of Incidence Studies of Pneumonia in Persons with Spinal Cord Injury |
| title_fullStr | Systematic Review of Incidence Studies of Pneumonia in Persons with Spinal Cord Injury |
| title_full_unstemmed | Systematic Review of Incidence Studies of Pneumonia in Persons with Spinal Cord Injury |
| title_short | Systematic Review of Incidence Studies of Pneumonia in Persons with Spinal Cord Injury |
| title_sort | systematic review of incidence studies of pneumonia in persons with spinal cord injury |
| topic | pneumonia spinal cord injury systematic review incidence |
| url | https://www.mdpi.com/2077-0383/11/1/211 |
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