Song SH, Sankary KM, Burns SP. Vital sign differences between septic patients with tetraplegia and paraplegia.
Spinal Cord Ser Cases 2022;
8:87. [PMID:
36433952 PMCID:
PMC9700738 DOI:
10.1038/s41394-022-00553-3]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 11/02/2022] [Accepted: 11/03/2022] [Indexed: 11/27/2022] Open
Abstract
STUDY DESIGN
Retrospective chart review.
OBJECTIVES
Sepsis is a leading preventable cause of death in patients with chronic spinal cord injury (SCI). Individuals with tetraplegia may exhibit different signs and symptoms of infection compared to those with paraplegia. In this study, we examine differences in vital signs (VS) and mental status between septic patients with tetraplegia and paraplegia with the goal of improving early identification of sepsis in this population.
SETTING
Veterans hospital in Washington, USA.
METHODS
Participants consisted of 19 patients with tetraplegia and 16 with paraplegia who were transferred from an SCI Service to a higher level of care with sepsis between June 1, 2010 and June 1, 2018 (n = 35). We compared VS between patients with tetraplegia and paraplegia at baseline and during sepsis including temperature, heart rate (HR), and blood pressure as well as presence/absence of altered mental status (AMS).
RESULTS
While there were no significant VS differences between groups at baseline, septic patients with tetraplegia had lower maximum temperature (38.2 °C versus 39.2 °C, p = 0.003), lower maximum HR (106 versus 124 beats/minute, p = 0.004), and more frequent AMS compared to septic patients with paraplegia (79% versus 31%, p = 0.007).
CONCLUSION
Patients with tetraplegia may not be able to mount fever and tachycardia to the same degree as patients with paraplegia and may be more prone to developing AMS during sepsis. These findings suggest that changes to VS parameter cut-offs may improve sensitivity and be useful in identifying sepsis earlier in the tetraplegic population.
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