• Yunbo Jian and Zhengfeng Zhang.
• Department of Orthopedics, Xinqiao Hospital, Army Medical University, Chongqing, China.
• World Neurosurg. 2023 Feb 1; 170: e380e386e380-e386.

ObjectiveTo investigate the continuous relationship between age and tracheostomy in patients with traumatic cervical spinal cord injury (TCSCI).MethodsThis study comprised 689 TCSCI patients in total. The logistic regression and restricted cubic spline analysis was applied to analyze the possible dose-response relationship between age and tracheostomy. The subgroup analysis was performed for the American Spinal Injury Association (ASIA) grade and neurological level of injury.ResultsThe proportion of patients with the age ≥60 was significantly higher in the tracheostomy group than in the non-tracheostomy group (42.2% vs. 19.6%; P < 0.001). Age ≥60 was independently associated with tracheostomy (total: odds ratio = 3.560, 95% confidence interval: 1.892-6.697; P < 0.001) after adjusting for gender, smoking history, dislocation, respiratory complications, ASIA grade, neurological level of injury, preexisting lung disease, brain injury, and thoracic injury. After the relationship was presented in the subgroup analysis, the restricted cubic spline revealed a nonlinear relationship between age and tracheostomy (P-overall < 0.001 and P-nonlinear = 0.021).ConclusionsAge and tracheostomy present a dose-response relationship in patients with TCSCI. This finding could help physicians bring assistance in the early identification of tracheostomy and rationalize the allocation of medical resources.Copyright © 2022 Elsevier Inc. All rights reserved.

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