{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T16:58:44Z","timestamp":1790441924635,"version":"4.1.0"},"reference-count":15,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T00:00:00Z","timestamp":1790035200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["The American Surgeon\u2122"],"abstract":"<jats:p>\n                    Risk factors and timing of tracheostomy for spinal cord injury (SCI) have been identified. However, how these factors are incorporated into clinical decision-making remains unclear. This study aimed to identify the factors associated with tracheostomy placement across the spinal cord and evaluate tracheostomy in high-risk patients with SCI. Patients with traumatic SCI were evaluated between January 2016 and December 2024, using univariate and multivariate logistic regression analyses. Tracheostomy timing was compared with recommendations of \u226410\u00a0days for high-risk patients with SCI. High-risk patients were those with complete SCI, injury \u2264C7, injury severity score (ISS) &gt;16, age \u226545\u00a0years, smoking history, or chronic respiratory disease. Among 674 included patients, 46 underwent tracheostomy. Diabetes (odds ratios (ORs) 3.12, 95% CI: 1.50-6.49;\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    =0.002), COPD (OR: 3.60, 95% CI: 1.46-8.88;\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    = 0.005), increasing ISS (OR: 1.22, 95% CI: 1.09-1.36;\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    &lt; 0.001), primary injuries involving C5-C7 (OR: 12.36, 95% CI: 1.36-112.36;\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    = 0.026), and complete SCI (OR: 9.86, 95% CI: 3.03-32.08;\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    &lt; 0.001) were associated with tracheostomy placement. In total, 29\/46 (63%) tracheostomies occurred after 10\u00a0days, with no difference in complication rates (70.6% vs 72.4%). Cervical stabilization did not delay the tracheostomy. Posterior stabilization showed the shortest time (9.0 \u00b1 2.9 vs 11.4 \u00b1 5.9\u00a0days). Most high-risk patients with SCI underwent tracheostomy beyond the recommended 10-day window, highlighting challenges in translating guideline recommendations into practice. This suggests that recognized risk factors may serve as triggers for early tracheostomy.\n                  <\/jats:p>","DOI":"10.1177\/00031348261491674","type":"journal-article","created":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T15:28:59Z","timestamp":1790090939000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Risk Factors for Tracheostomy in Traumatic Spinal Cord Injury Patients: A Level 1 Trauma Center Study and Performance Analysis"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-9235-5651","authenticated-orcid":false,"given":"Anthony J.","family":"Buzzetta","sequence":"first","affiliation":[{"name":"Medical College, Albany Medical College"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nahla","family":"Haque","sequence":"additional","affiliation":[{"name":"Medical College, Albany Medical College"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashar","family":"Ata","sequence":"additional","affiliation":[{"name":"Department of Trauma and Surgical Critical Care, Albany, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marisha","family":"Schwab","sequence":"additional","affiliation":[{"name":"Department of Trauma and Surgical Critical Care, Albany, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicole K.","family":"Post","sequence":"additional","affiliation":[{"name":"Medical College, Albany Medical College"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-5069-5829","authenticated-orcid":false,"given":"Ethan D.","family":"Paliwoda","sequence":"additional","affiliation":[{"name":"Medical College, Albany Medical College"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen","family":"Martone","sequence":"additional","affiliation":[{"name":"Department of Trauma and Surgical Critical Care, Albany, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samantha","family":"Thomas","sequence":"additional","affiliation":[{"name":"Department of Trauma and Surgical Critical Care, Albany, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Deroo","sequence":"additional","affiliation":[{"name":"Department of Trauma and Surgical Critical Care, Albany, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kurt","family":"Edwards","sequence":"additional","affiliation":[{"name":"Department of Trauma and Surgical Critical Care, Albany, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcel","family":"Tafen","sequence":"additional","affiliation":[{"name":"Department of Trauma and Surgical Critical Care, Albany, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amy","family":"Howk","sequence":"additional","affiliation":[{"name":"Department of Trauma and Surgical Critical Care, Albany, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,9,22]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjsurg.2014.01.001"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41393-020-0506-7"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjsurg.2024.116033"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1097\/BRS.0b013e31827417f1"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjsurg.2014.07.016"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1111\/os.13172"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00586-009-1097-3"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.3340\/jkns.2013.54.3.220"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.3171\/spi.2004.100.1.0020"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1136\/tsaco-2023-001338"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1186\/1748-5908-7-103"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1007\/s12028-022-01551-x"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1001\/archsurg.142.7.613"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-023-30461-x"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00125-007-0856-0"}],"container-title":["The 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