Long-Term Pulmonary Function Postspinal Cord Injury

• Published in: Archives of physical medicine and rehabilitation Vol. 105; no. 11; pp. 2142 - 2149
• Main Authors: Sho, Keun Young, Mun, Chaeun, Lim, Jin-Cheol, Kim, Onyoo, Lee, Jang Woo
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-11-2024
• Subjects: Forced expiratory volume; Forced vital capacity; Longitudinal studies; Rehabilitation; Spinal cord injury; FVC; GAM; Forced vital capacity; SCI; Forced expiratory volume; Longitudinal studies; FEV1; Rehabilitation; AIS; Spinal cord injury; BMI; PFT
• ISSN: 0003-9993; 1532-821X; 1532-821X
• DOI: 10.1016/j.apmr.2024.07.007

•Forced vital capacity and expiratory volume first improved but declined by year 6.•Motor completeness influenced pulmonary function improvement and decline.
To investigate mean values of pulmonary function tests (PFT) at specific time points to assess long-term progression in patients with spinal cord injury (SCI).
Retrospective cohort study from 1997-2022.
National 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.
This 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.
Not applicable.
Changes 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.
Significant 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.
Pulmonary 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.