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Type: Journal article
Title: Cardiac pacing in patients with a cervical spinal cord injury
Author: Rangappa, P.
Jeyadoss, J.
Flabouris, A.
Clark, J.
Marshall, R.
Citation: Spinal Cord, 2010; 48(12):867-871
Publisher: Nature Publishing Group
Issue Date: 2010
ISSN: 1362-4393
Statement of
P Rangappa, J Jeyadoss, A Flabouris, JM Clark and R Marshall
Abstract: Study design: Retrospective medical record review. Objectives: To compare patients, admitted to an intensive care unit (ICU) with an acute cervical spinal cord injury (SCI) and documented motor deficit, who did, with those who did not, require a cardiac pacemaker. Setting: South Australian Tertiary Referral Intensive Care and Spinal Injury Unit. Methods: Retrospective medical record review and data set linkage. Results: From 1995 to 2007, 465 patients sustained a cervical SCI. Of these, 30 (6.5%) were admitted to ICU with a clinically assessable motor deficit and 3 (0.6% of all patients, or 10% of those admitted to ICU) required a cardiac pacemaker. All three patients had a cervical SCI, C5 (American Spinal Injury Association A) tetraplegia, and required invasive mechanical respiratory and inotropic support and a tracheostomy for weaning. Two patients (66%) were discharged alive to rehabilitation. Patients requiring a pacemaker had bradycardic episodes over a longer period (11 vs 4 days, P¼0.01), a trend towards a later onset of bradycardia (8 vs 1.5 days, P¼0.05) and a longer ICU length of stay (37 vs 10 days, P¼0.02). Conclusion: Patients with a cervical SCI requiring a cardiac pacemaker are characterized by a higher level of SCI injury and motor loss, require mechanical respiratory and inotropic support, a tracheostomy to wean, and bradycardic episodes of a later onset and over a longer period of time. These findings suggest that such patients should be managed at hospitals with specialized acute spinal injury, intensive care and cardiac pacemaker services.
Keywords: cervical spinal cord injury
cardiovascular instability
cardiac pacemaker
Rights: Copyright 2010 International Spinal Cord Society
DOI: 10.1038/sc.2010.48
Appears in Collections:Aurora harvest
Surgery publications

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