Impact of malnutrition on mortality and neurological recovery of older patients with spinal cord injury

Koji Tamai; Hidetomi Terai; Hiroaki Nakamura; Noriaki Yokogawa; Takeshi Sasagawa; Hiroaki Nakashima; Naoki Segi; Sadayuki Ito; Toru Funayama; Fumihiko Eto; Akihiro Yamaji; Kota Watanabe; Junichi Yamane; Kazuki Takeda; Takeo Furuya; Atsushi Yunde; Hideaki Nakajima; Tomohiro Yamada; Tomohiko Hasegawa; Yoshinori Terashima; Ryosuke Hirota; Hidenori Suzuki; Yasuaki Imajo; Shota Ikegami; Masashi Uehara; Hitoshi Tonomura; Munehiro Sakata; Ko Hashimoto; Yoshito Onoda; Kenichi Kawaguchi; Yohei Haruta; Nobuyuki Suzuki; Kenji Kato; Hiroshi Uei; Hirokatsu Sawada; Kazuo Nakanishi; Kosuke Misaki; Akiyoshi Kuroda; Gen Inoue; Kenichiro Kakutani; Yuji Kakiuchi; Katsuhito Kiyasu; Hiroyuki Tominaga; Hiroto Tokumoto; Yoichi Iizuka; Eiji Takasawa; Koji Akeda; Norihiko Takegami; Haruki Funao; Yasushi Oshima; Takashi Kaito; Daisuke Sakai; Toshitaka Yoshii; Tetsuro Ohba; Bungo Otsuki; Shoji Seki; Masashi Miyazaki; Masayuki Ishihara; Seiji Okada; Shiro Imagama; Satoshi Kato

doi:10.1038/s41598-024-56527-y

Impact of malnutrition on mortality and neurological recovery of older patients with spinal cord injury

Koji Tamai, Hidetomi Terai, Hiroaki Nakamura, Noriaki Yokogawa, Takeshi Sasagawa, Hiroaki Nakashima, Naoki Segi, Sadayuki Ito, Toru Funayama, Fumihiko Eto, Akihiro Yamaji, Kota Watanabe, Junichi Yamane, Kazuki Takeda, Takeo Furuya, Atsushi Yunde, Hideaki Nakajima, Tomohiro Yamada, Tomohiko Hasegawa, Yoshinori TerashimaRyosuke Hirota, Hidenori Suzuki, Yasuaki Imajo, Shota Ikegami, Masashi Uehara, Hitoshi Tonomura, Munehiro Sakata, Ko Hashimoto, Yoshito Onoda, Kenichi Kawaguchi, Yohei Haruta, Nobuyuki Suzuki, Kenji Kato, Hiroshi Uei, Hirokatsu Sawada, Kazuo Nakanishi, Kosuke Misaki, Akiyoshi Kuroda, Gen Inoue, Kenichiro Kakutani, Yuji Kakiuchi, Katsuhito Kiyasu, Hiroyuki Tominaga, Hiroto Tokumoto, Yoichi Iizuka, Eiji Takasawa, Koji Akeda, Norihiko Takegami, Haruki Funao, Yasushi Oshima, Takashi Kaito, Daisuke Sakai, Toshitaka Yoshii, Tetsuro Ohba, Bungo Otsuki, Shoji Seki, Masashi Miyazaki, Masayuki Ishihara, Seiji Okada, Shiro Imagama, Satoshi Kato

School of Medicine

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Abstract

This retrospective cohort study established malnutrition’s impact on mortality and neurological recovery of older patients with cervical spinal cord injury (SCI). It included patients aged ≥ 65 years with traumatic cervical SCI treated conservatively or surgically. The Geriatric Nutritional Risk Index was calculated to assess nutritional-related risk. Overall, 789 patients (mean follow-up: 20.1 months) were examined and 47 had major nutritional-related risks on admission. One-year mortality rate, median survival time, neurological recovery, and activities of daily living (ADL) at 1 year post-injury were compared between patients with major nutrition-related risk and matched controls selected using 1:2 propensity score matching to adjust for age, pre-traumatic neurological impairment, and activity. In the Kaplan–Meier analysis, the median survival times were 44.9 and 76.5 months for patients with major nutrition-related risk and matched controls, respectively (p = 0.015). Matched controls had more individuals with a neurological improvement of American Spinal Injury Association Impairment Scale ≥ 1 grade (p = 0.039) and independence in ADL at 1 year post-injury than patients with major nutrition-related risk (p < 0.05). In conclusion, 6% of older patients with cervical SCI had major nutrition-related risks; they showed a significantly higher 1 year mortality rate, shorter survival time, poorer neurological improvement, and lower ADL at 1 year post-injury than matched controls.

Original language	English
Article number	5853
Journal	Scientific Reports
Volume	14
Issue number	1
DOIs	https://doi.org/10.1038/s41598-024-56527-y
Publication status	Published - Dec 2024

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10.1038/s41598-024-56527-y

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Tamai, K., Terai, H., Nakamura, H., Yokogawa, N., Sasagawa, T., Nakashima, H., Segi, N., Ito, S., Funayama, T., Eto, F., Yamaji, A., Watanabe, K., Yamane, J., Takeda, K., Furuya, T., Yunde, A., Nakajima, H., Yamada, T., Hasegawa, T., ... Kato, S. (2024). Impact of malnutrition on mortality and neurological recovery of older patients with spinal cord injury. Scientific Reports, 14(1), Article 5853. https://doi.org/10.1038/s41598-024-56527-y

@article{fc8242ab23514da098df8229374f0ec0,

title = "Impact of malnutrition on mortality and neurological recovery of older patients with spinal cord injury",

abstract = "This retrospective cohort study established malnutrition{\textquoteright}s impact on mortality and neurological recovery of older patients with cervical spinal cord injury (SCI). It included patients aged ≥ 65 years with traumatic cervical SCI treated conservatively or surgically. The Geriatric Nutritional Risk Index was calculated to assess nutritional-related risk. Overall, 789 patients (mean follow-up: 20.1 months) were examined and 47 had major nutritional-related risks on admission. One-year mortality rate, median survival time, neurological recovery, and activities of daily living (ADL) at 1 year post-injury were compared between patients with major nutrition-related risk and matched controls selected using 1:2 propensity score matching to adjust for age, pre-traumatic neurological impairment, and activity. In the Kaplan–Meier analysis, the median survival times were 44.9 and 76.5 months for patients with major nutrition-related risk and matched controls, respectively (p = 0.015). Matched controls had more individuals with a neurological improvement of American Spinal Injury Association Impairment Scale ≥ 1 grade (p = 0.039) and independence in ADL at 1 year post-injury than patients with major nutrition-related risk (p < 0.05). In conclusion, 6% of older patients with cervical SCI had major nutrition-related risks; they showed a significantly higher 1 year mortality rate, shorter survival time, poorer neurological improvement, and lower ADL at 1 year post-injury than matched controls.",

author = "Koji Tamai and Hidetomi Terai and Hiroaki Nakamura and Noriaki Yokogawa and Takeshi Sasagawa and Hiroaki Nakashima and Naoki Segi and Sadayuki Ito and Toru Funayama and Fumihiko Eto and Akihiro Yamaji and Kota Watanabe and Junichi Yamane and Kazuki Takeda and Takeo Furuya and Atsushi Yunde and Hideaki Nakajima and Tomohiro Yamada and Tomohiko Hasegawa and Yoshinori Terashima and Ryosuke Hirota and Hidenori Suzuki and Yasuaki Imajo and Shota Ikegami and Masashi Uehara and Hitoshi Tonomura and Munehiro Sakata and Ko Hashimoto and Yoshito Onoda and Kenichi Kawaguchi and Yohei Haruta and Nobuyuki Suzuki and Kenji Kato and Hiroshi Uei and Hirokatsu Sawada and Kazuo Nakanishi and Kosuke Misaki and Akiyoshi Kuroda and Gen Inoue and Kenichiro Kakutani and Yuji Kakiuchi and Katsuhito Kiyasu and Hiroyuki Tominaga and Hiroto Tokumoto and Yoichi Iizuka and Eiji Takasawa and Koji Akeda and Norihiko Takegami and Haruki Funao and Yasushi Oshima and Takashi Kaito and Daisuke Sakai and Toshitaka Yoshii and Tetsuro Ohba and Bungo Otsuki and Shoji Seki and Masashi Miyazaki and Masayuki Ishihara and Seiji Okada and Shiro Imagama and Satoshi Kato",

note = "Publisher Copyright: {\textcopyright} The Author(s) 2024.",

year = "2024",

month = dec,

doi = "10.1038/s41598-024-56527-y",

language = "English",

volume = "14",

journal = "Scientific Reports",

issn = "2045-2322",

number = "1",

}

Tamai, K, Terai, H, Nakamura, H, Yokogawa, N, Sasagawa, T, Nakashima, H, Segi, N, Ito, S, Funayama, T, Eto, F, Yamaji, A, Watanabe, K, Yamane, J, Takeda, K, Furuya, T, Yunde, A, Nakajima, H, Yamada, T, Hasegawa, T, Terashima, Y, Hirota, R, Suzuki, H, Imajo, Y, Ikegami, S, Uehara, M, Tonomura, H, Sakata, M, Hashimoto, K, Onoda, Y, Kawaguchi, K, Haruta, Y, Suzuki, N, Kato, K, Uei, H, Sawada, H, Nakanishi, K, Misaki, K, Kuroda, A, Inoue, G, Kakutani, K, Kakiuchi, Y, Kiyasu, K, Tominaga, H, Tokumoto, H, Iizuka, Y, Takasawa, E, Akeda, K, Takegami, N, Funao, H, Oshima, Y, Kaito, T, Sakai, D, Yoshii, T, Ohba, T, Otsuki, B, Seki, S, Miyazaki, M, Ishihara, M, Okada, S, Imagama, S & Kato, S 2024, 'Impact of malnutrition on mortality and neurological recovery of older patients with spinal cord injury', Scientific Reports, vol. 14, no. 1, 5853. https://doi.org/10.1038/s41598-024-56527-y

TY - JOUR

T1 - Impact of malnutrition on mortality and neurological recovery of older patients with spinal cord injury

AU - Tamai, Koji

AU - Terai, Hidetomi

AU - Nakamura, Hiroaki

AU - Yokogawa, Noriaki

AU - Sasagawa, Takeshi

AU - Nakashima, Hiroaki

AU - Segi, Naoki

AU - Ito, Sadayuki

AU - Funayama, Toru

AU - Eto, Fumihiko

AU - Yamaji, Akihiro

AU - Watanabe, Kota

AU - Yamane, Junichi

AU - Takeda, Kazuki

AU - Furuya, Takeo

AU - Yunde, Atsushi

AU - Nakajima, Hideaki

AU - Yamada, Tomohiro

AU - Hasegawa, Tomohiko

AU - Terashima, Yoshinori

AU - Hirota, Ryosuke

AU - Suzuki, Hidenori

AU - Imajo, Yasuaki

AU - Ikegami, Shota

AU - Uehara, Masashi

AU - Tonomura, Hitoshi

AU - Sakata, Munehiro

AU - Hashimoto, Ko

AU - Onoda, Yoshito

AU - Kawaguchi, Kenichi

AU - Haruta, Yohei

AU - Suzuki, Nobuyuki

AU - Kato, Kenji

AU - Uei, Hiroshi

AU - Sawada, Hirokatsu

AU - Nakanishi, Kazuo

AU - Misaki, Kosuke

AU - Kuroda, Akiyoshi

AU - Inoue, Gen

AU - Kakutani, Kenichiro

AU - Kakiuchi, Yuji

AU - Kiyasu, Katsuhito

AU - Tominaga, Hiroyuki

AU - Tokumoto, Hiroto

AU - Iizuka, Yoichi

AU - Takasawa, Eiji

AU - Akeda, Koji

AU - Takegami, Norihiko

AU - Funao, Haruki

AU - Oshima, Yasushi

AU - Kaito, Takashi

AU - Sakai, Daisuke

AU - Yoshii, Toshitaka

AU - Ohba, Tetsuro

AU - Otsuki, Bungo

AU - Seki, Shoji

AU - Miyazaki, Masashi

AU - Ishihara, Masayuki

AU - Okada, Seiji

AU - Imagama, Shiro

AU - Kato, Satoshi

PY - 2024/12

Y1 - 2024/12

N2 - This retrospective cohort study established malnutrition’s impact on mortality and neurological recovery of older patients with cervical spinal cord injury (SCI). It included patients aged ≥ 65 years with traumatic cervical SCI treated conservatively or surgically. The Geriatric Nutritional Risk Index was calculated to assess nutritional-related risk. Overall, 789 patients (mean follow-up: 20.1 months) were examined and 47 had major nutritional-related risks on admission. One-year mortality rate, median survival time, neurological recovery, and activities of daily living (ADL) at 1 year post-injury were compared between patients with major nutrition-related risk and matched controls selected using 1:2 propensity score matching to adjust for age, pre-traumatic neurological impairment, and activity. In the Kaplan–Meier analysis, the median survival times were 44.9 and 76.5 months for patients with major nutrition-related risk and matched controls, respectively (p = 0.015). Matched controls had more individuals with a neurological improvement of American Spinal Injury Association Impairment Scale ≥ 1 grade (p = 0.039) and independence in ADL at 1 year post-injury than patients with major nutrition-related risk (p < 0.05). In conclusion, 6% of older patients with cervical SCI had major nutrition-related risks; they showed a significantly higher 1 year mortality rate, shorter survival time, poorer neurological improvement, and lower ADL at 1 year post-injury than matched controls.

AB - This retrospective cohort study established malnutrition’s impact on mortality and neurological recovery of older patients with cervical spinal cord injury (SCI). It included patients aged ≥ 65 years with traumatic cervical SCI treated conservatively or surgically. The Geriatric Nutritional Risk Index was calculated to assess nutritional-related risk. Overall, 789 patients (mean follow-up: 20.1 months) were examined and 47 had major nutritional-related risks on admission. One-year mortality rate, median survival time, neurological recovery, and activities of daily living (ADL) at 1 year post-injury were compared between patients with major nutrition-related risk and matched controls selected using 1:2 propensity score matching to adjust for age, pre-traumatic neurological impairment, and activity. In the Kaplan–Meier analysis, the median survival times were 44.9 and 76.5 months for patients with major nutrition-related risk and matched controls, respectively (p = 0.015). Matched controls had more individuals with a neurological improvement of American Spinal Injury Association Impairment Scale ≥ 1 grade (p = 0.039) and independence in ADL at 1 year post-injury than patients with major nutrition-related risk (p < 0.05). In conclusion, 6% of older patients with cervical SCI had major nutrition-related risks; they showed a significantly higher 1 year mortality rate, shorter survival time, poorer neurological improvement, and lower ADL at 1 year post-injury than matched controls.

UR - http://www.scopus.com/inward/record.url?scp=85187465815&partnerID=8YFLogxK

U2 - 10.1038/s41598-024-56527-y

DO - 10.1038/s41598-024-56527-y

M3 - Article

C2 - 38462665

AN - SCOPUS:85187465815

SN - 2045-2322

VL - 14

JO - Scientific Reports

JF - Scientific Reports

IS - 1

M1 - 5853

ER -

Impact of malnutrition on mortality and neurological recovery of older patients with spinal cord injury

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