Plasma fibrinogen levels increase pulmonary infection risk among spinal cord injury patients: Study

A recent study published in the journal of BMC Pulmonary Medicine showed that elevated plasma fibrinogen levels dramatically raise the risk of pulmonary infections (PI) in individuals with spinal cord injury (SCI). Pulmonary infections are a major source of morbidity and mortality in this group and were far more likely to occur in patients with spinal cord injury. Due in part to respiratory myasthenia, which impairs lung function and coughing capacity and is frequent following SCI, such infections are more dangerous for individuals with SCI. Respiratory dysfunction appeared as one of the most severe and potentially deadly effects for individuals with cervical SCI, whereas pneumonia was a prevalent and major complication.

Aspiration pneumonia and mechanical airway blockage are two more severe consequences that can arise in individuals with traumatic cervical SCI who have swallowing difficulty. Pulmonary infections are more common in patients with spinal cord injuries, and plasma fibrinogen levels may be a risk factor for PI in and of itself. Thus, to clarify the relationship between plasma fibrinogen levels and the incidence of PI in SCI patients, Jinlong Zhang and her colleagues carried out this investigation.

A total of 576 SCI patients who received treatment in the Rehabilitation Medicine Department from January 1, 2017 and December 31, 2021, were the subject of this review. After exclusions, 139 PI instances were found among the 491 patients that made it into the final study. The association between fibrinogen level and PI incidence included confounders like surgery, degree of damage, and chest comorbidities.

Age, D-dimer level, deep vein thrombosis (DVT), UTI, anticoagulant medication, injury mechanism, and the American Spinal Injury Association Impairment Scale (AIS) grades were among the other possible risk factors for PI that were found. After controlling for these variables, this study discovered that the risk of PI increased by 18% for every 1 g/L rise in fibrinogen level (HR = 1.18, P = 0.011) that suggested a positive linear connection between fibrinogen level and PI incidence.

Overall, the plasma fibrinogen level has found to be an independent predictor of PI risk, particularly for AIS-B and C grades in individuals with SCI. The prevalence of PI in this susceptible group may be reduced with proactive fibrinogen level control after admission by highlighting the necessity of focused treatments in the rehabilitation medicine division.

Reference:

Zhang, J., Wang, C., & He, C. (2024). Plasma fibrinogen level is independent risk factor associated with the incidence of pulmonary infection in patients with spinal cord injury: a retrospective cohort study. In BMC Pulmonary Medicine (Vol. 24, Issue 1). Springer Science and Business Media LLC. https://doi.org/10.1186/s12890-024-03332-y