Prevalence of Complications of Patients Treated With Steroids for Acute Subaxial Cervical Spinal Cord Injuries

Study design: Retrospective chart review. Objective: To evaluate the prevalence of complications in traumatic spinal cord injury (SCI) patients treated with a modified dose of methylprednisolone (MP) at our institution. Summary of Background Data: Treatment concerning the use of corticosteroids for SCI remains controversial. High-dose MP initially was shown to aid neurologic recovery in SCI if administered acutely; however, reports of complications, including gastrointestinal (GI) hemorrhage, urinary tract infection, upper respiratory infections, and sacral decubitus ulcers, changed recommendations. These complications may also result due to the injury itself, or the ICU-related care these patients typically require. Methods: Adult patients with SCI from January 1, 2015 to April 25, 2023 using ICD-10 codes at our ACS level 1 institution were retrospectively reviewed. Patients with concurrent head trauma or gastrointestinal injuries were excluded. Demographic and clinical data were collected, and complication rates were analyzed. Predictive factors for complications occurring >10% were assessed using χ2 for categorical data and Mann-Whitney for continuous data. P ≤ 0.05 and 95% CI for significance value. Results: Ninety-six patients were included (age 57.42 ± 17.40 y; 72 males, 24 females). Average hospital stay was 17.27 ± 15.17 days, and ICU stay 9.36 ± 13.36 days. The most common complications were pneumonia, anemia, dysphagia, and leukocytosis. GI hemorrhage occurred in 4.2% of patients, with transfusion as the only predictor (P < 0.001). Conclusions: ICU length of stay was predictive of 4 of the 5 most commonly occurring complications in our cohort. GI hemorrhage, often cited as a deterrent for MP use, was observed in only 4.2% of cases.