Article

Chest illnesses commonly cause morbidity in persons with chronic
spinal cord injury. Risk factors remain poorly characterized because previous
studies have not accounted for factors other than spinal cord injury. DESIGN:
Between 1994 and 2005, 403 participants completed a respiratory questionnaire and
underwent spirometry. Participants were contacted at a median of 1.7 yrs
[interquartile range: 1.3-2.5 yrs] apart over a mean (SD) of 5.1 +/- 3.0 yrs and
asked to report chest illnesses that had resulted in time off work, spent
indoors, or in bed since prior contact. RESULTS: In 97 participants, there were
247 chest illnesses (0.12/person-year) with 54 hospitalizations (22%). Spinal
cord injury level, completeness of injury, and duration of injury were not
associated with illness risk. Adjusting for age and smoking history, any wheeze
(relative risk = 1.92; 95% confidence interval: 1.19, 3.08), pneumonia or
bronchitis since spinal cord injury (relative risk = 2.29; 95% confidence
interval: 1.40, 3.75), and physician-diagnosed chronic obstructive pulmonary
disease (relative risk = 2.17; 95% confidence interval: 1.08, 4.37) were
associated with a greater risk of chest illness. Each percent-predicted decrease
in forced expiratory volume in 1 sec was associated with a 1.2% increase in risk
of chest illness (P = 0.030). CONCLUSIONS: In chronic spinal cord injury, chest
illness resulting in time spent away from usual activities was not related to the
level or completeness of spinal cord injury but was related to reduced pulmonary
function, wheeze, chronic obstructive pulmonary disease, a history of pneumonia
and bronchitis, and smoking.

Langue : ANGLAIS