Respiratory function and respiratory complications in spinal cord injury: protocol for a prospective, multicentre cohort study in high-income countries

Introduction Pneumonia is one of the leading complications and causes of death after a spinal cord injury (SCI). After a cervical or thoracic lesion, impairment of the respiratory muscles decreases respiratory function, which increases the risk of respiratory complications. Pneumonia substantially r...

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Main Authors: David J Berlowitz, Maria T E Hopman, Martin Schubert, Gabi Mueller, Martin W G Brinkhof, Xavier Jordan, Anja M Raab, Karin Postma, David Gobets, Sven Hirschfeld, Burkhart Huber, Margret Hund-Georgiadis, Renate Wildburger
Format: Article
Language:English
Published: BMJ Publishing Group 2020-11-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/10/11/e038204.full
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author David J Berlowitz
Maria T E Hopman
Martin Schubert
Gabi Mueller
Martin W G Brinkhof
Xavier Jordan
Anja M Raab
Karin Postma
David Gobets
Sven Hirschfeld
Burkhart Huber
Margret Hund-Georgiadis
Renate Wildburger
author_facet David J Berlowitz
Maria T E Hopman
Martin Schubert
Gabi Mueller
Martin W G Brinkhof
Xavier Jordan
Anja M Raab
Karin Postma
David Gobets
Sven Hirschfeld
Burkhart Huber
Margret Hund-Georgiadis
Renate Wildburger
author_sort David J Berlowitz
collection DOAJ
description Introduction Pneumonia is one of the leading complications and causes of death after a spinal cord injury (SCI). After a cervical or thoracic lesion, impairment of the respiratory muscles decreases respiratory function, which increases the risk of respiratory complications. Pneumonia substantially reduces patient’s quality of life, may prolong inpatient rehabilitation time, increase healthcare costs or at worse, lead to early death. Respiratory function and coughing can be improved through various interventions after SCI, but the available evidence as to which aspect of respiratory care should be optimised is inconclusive. Furthermore, ability of respiratory function parameters to predict pneumonia risk is insufficiently established. This paper details the protocol for a large-scale, multicentre research project that aims to evaluate the ability of parameters of respiratory function to predict and understand variation in inpatient risk of pneumonia in SCI.Methods and analysis RESCOM, a prospective cohort study, began recruitment in October 2016 across 10 SCI rehabilitation centres from Australia, Austria, Germany, the Netherlands and Switzerland. Inpatients with acute SCI, with complete or incomplete cervical or thoracic lesions, 18 years or older and not/no more dependent on 24-hour mechanical ventilation within the first 3 months after injury are eligible for inclusion. The target sample size is 500 participants. The primary outcome is an occurrence of pneumonia; secondary outcomes include pneumonia-related mortality and quality of life. We will use the longitudinal data for prognostic models on inpatient pneumonia risk factors.Ethics and dissemination The study has been reviewed and approved by all local ethics committees of all participating centres. Study results will be disseminated to the scientific community through peer-reviewed journals and conference presentations, to the SCI community, other stakeholders and via social media, newsletters and engagement activities.Trial registration details ClinicalTrials.gov NCT02891096.
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spelling doaj-art-649f3eec62884868b6723b6e6ce7a1ee2025-08-20T02:33:31ZengBMJ Publishing GroupBMJ Open2044-60552020-11-01101110.1136/bmjopen-2020-038204Respiratory function and respiratory complications in spinal cord injury: protocol for a prospective, multicentre cohort study in high-income countriesDavid J Berlowitz0Maria T E Hopman1Martin Schubert2Gabi Mueller3Martin W G Brinkhof4Xavier Jordan5Anja M Raab6Karin Postma7David Gobets8Sven Hirschfeld9Burkhart Huber10Margret Hund-Georgiadis11Renate Wildburger12Department of Respiratory and Sleep Medicine, Institute for Breathing and Sleep, Heidelberg, Victoria, Australia1 Department of Physiology, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The NetherlandsSpinal Cord Injury Center, Balgrist University Hospital, Zurich, SwitzerlandClinical Trial Unit, Swiss Paraplegic Center, Nottwil, SwitzerlandSwiss Paraplegic Research, Nottwil, SwitzerlandSpinal Cord Injury Department, Clinique romande de réadaptation, Sion, SwitzerlandClinical Trial Unit, Swiss Paraplegic Center, Nottwil, SwitzerlandDepartment of Rehabilitation Medicine, Rijndam Rehabilitation and Erasmus MC, University Medical Center Rotterdam, Rotterdam, The NetherlandsDepartment of Rehabilitation Medicine, Heliomare Rehabilitation Center, Wijk aan Zee, The NetherlandsDepartment of Spinal Cord Medicine, BG Trauma Hospital, Hamburg, GermanyTrauma Surgery, AUVA Rehabilitation Center Häring, Bad Häring, AustriaClinic for neurorehabilitation and paraplegiology, REHAB Basel, Basel, SwitzerlandAllgemeine Unfallversicherungsanstalt, AUVA Rehabilitation Clinic Tobelbad, Tobelbad, AustriaIntroduction Pneumonia is one of the leading complications and causes of death after a spinal cord injury (SCI). After a cervical or thoracic lesion, impairment of the respiratory muscles decreases respiratory function, which increases the risk of respiratory complications. Pneumonia substantially reduces patient’s quality of life, may prolong inpatient rehabilitation time, increase healthcare costs or at worse, lead to early death. Respiratory function and coughing can be improved through various interventions after SCI, but the available evidence as to which aspect of respiratory care should be optimised is inconclusive. Furthermore, ability of respiratory function parameters to predict pneumonia risk is insufficiently established. This paper details the protocol for a large-scale, multicentre research project that aims to evaluate the ability of parameters of respiratory function to predict and understand variation in inpatient risk of pneumonia in SCI.Methods and analysis RESCOM, a prospective cohort study, began recruitment in October 2016 across 10 SCI rehabilitation centres from Australia, Austria, Germany, the Netherlands and Switzerland. Inpatients with acute SCI, with complete or incomplete cervical or thoracic lesions, 18 years or older and not/no more dependent on 24-hour mechanical ventilation within the first 3 months after injury are eligible for inclusion. The target sample size is 500 participants. The primary outcome is an occurrence of pneumonia; secondary outcomes include pneumonia-related mortality and quality of life. We will use the longitudinal data for prognostic models on inpatient pneumonia risk factors.Ethics and dissemination The study has been reviewed and approved by all local ethics committees of all participating centres. Study results will be disseminated to the scientific community through peer-reviewed journals and conference presentations, to the SCI community, other stakeholders and via social media, newsletters and engagement activities.Trial registration details ClinicalTrials.gov NCT02891096.https://bmjopen.bmj.com/content/10/11/e038204.full
spellingShingle David J Berlowitz
Maria T E Hopman
Martin Schubert
Gabi Mueller
Martin W G Brinkhof
Xavier Jordan
Anja M Raab
Karin Postma
David Gobets
Sven Hirschfeld
Burkhart Huber
Margret Hund-Georgiadis
Renate Wildburger
Respiratory function and respiratory complications in spinal cord injury: protocol for a prospective, multicentre cohort study in high-income countries
BMJ Open
title Respiratory function and respiratory complications in spinal cord injury: protocol for a prospective, multicentre cohort study in high-income countries
title_full Respiratory function and respiratory complications in spinal cord injury: protocol for a prospective, multicentre cohort study in high-income countries
title_fullStr Respiratory function and respiratory complications in spinal cord injury: protocol for a prospective, multicentre cohort study in high-income countries
title_full_unstemmed Respiratory function and respiratory complications in spinal cord injury: protocol for a prospective, multicentre cohort study in high-income countries
title_short Respiratory function and respiratory complications in spinal cord injury: protocol for a prospective, multicentre cohort study in high-income countries
title_sort respiratory function and respiratory complications in spinal cord injury protocol for a prospective multicentre cohort study in high income countries
url https://bmjopen.bmj.com/content/10/11/e038204.full
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