Long-Term Pulmonary Function Postspinal Cord Injury

Abstract

ObjectiveTo investigate mean values of pulmonary function tests (PFT) at specific time points to assess long-term progression in patients with spinal cord injury (SCI). DesignRetrospective cohort study from 1997-2022. SettingNational rehabilitation hospital, providing scheduled admission for potential SCI-related issues. Follow-up assessments are recommended annually, guiding the observation period into consecutive 1-year intervals. ParticipantsThis study included 1394 adult patients who were admitted at least twice to the National Rehabilitation Center between 1997 and 2022, selected from an initial pool of 1510. Overall, 116 patients were excluded owing to the absence of any PFT results. InterventionsNot applicable. Main Outcome MeasuresChanges in PFT values over time, specifically assessing for a potential 2-phase pattern after injury. The hypothesis that PFT values would initially improve before declining was formulated based on existing literature. ResultsSignificant changes in pulmonary function were noted among 1394 adults with SCI. Forced vital capacity (FVC) and forced expiratory volume in one second (FEV1) initially increased within the first 1-2 years after injury but declined to below baseline levels after 6 years. Pronounced changes occurred between <1 year and 1-2 years after injury (FVC: Δ=4.89, SE=0.87, P<.001; FEV1: Δ=4.28, SE=1.09, P=.002) and 1-2 years to >6 years (FVC: Δ= −5.83, SE=0.94, P<.001; FEV1: Δ= −6.49, SE=1.18, P<.001). No significant changes in the FEV1/FVC ratio. Motor completeness was significantly associated with the increase and decline phase, showing a steeper increase and less decline compared with the motor-incomplete group. ConclusionsPulmonary function in SCI initially increases but declines over time, falling below initial levels by 6 years. Further evaluation with more complete datasets is warranted to elucidate the factors influencing these changes.