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Systematic Review of Incidence Studies of Pneumonia in Persons with Spinal Cord Injury

Clinical Trial Unit, Swiss Paraplegic Centre, 6207 Nottwil, Switzerland
Department of Health Professions, Bern University of Applied Sciences, 3008 Bern, Switzerland
School of Health Sciences Valais, Physiotherapy, University of Applied Sciences and Arts Western Switzer Land Valais, 1950 Sion, Switzerland
Neuroscience Research Australia, Randwick 2031, Australia
School of Medical Sciences, University of New South Wales, Sydney 2052, Australia
Institute of Social and Preventive Medicine, University of Bern, 3012 Bern, Switzerland
Department of Physiology, Radboud University Nijmegen, 6525 Nijmegen, The Netherlands
Author to whom correspondence should be addressed.
Academic Editor: Satoru Ebihara
J. Clin. Med. 2022, 11(1), 211;
Received: 12 November 2021 / Revised: 23 December 2021 / Accepted: 26 December 2021 / Published: 31 December 2021
(This article belongs to the Special Issue Recent Advances in Pneumonia in Older People)
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. View Full-Text
Keywords: pneumonia; spinal cord injury; systematic review; incidence pneumonia; spinal cord injury; systematic review; incidence
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MDPI and ACS Style

Raab, A.M.; Mueller, G.; Elsig, S.; Gandevia, S.C.; Zwahlen, M.; Hopman, M.T.E.; Hilfiker, R. Systematic Review of Incidence Studies of Pneumonia in Persons with Spinal Cord Injury. J. Clin. Med. 2022, 11, 211.

AMA Style

Raab AM, Mueller G, Elsig S, Gandevia SC, Zwahlen M, Hopman MTE, Hilfiker R. Systematic Review of Incidence Studies of Pneumonia in Persons with Spinal Cord Injury. Journal of Clinical Medicine. 2022; 11(1):211.

Chicago/Turabian Style

Raab, Anja Maria, Gabi Mueller, Simone Elsig, Simon C. Gandevia, Marcel Zwahlen, Maria T. E. Hopman, and Roger Hilfiker. 2022. "Systematic Review of Incidence Studies of Pneumonia in Persons with Spinal Cord Injury" Journal of Clinical Medicine 11, no. 1: 211.

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