Stolzmann et al studied risk factors for chest illness in patients with chronic spinal cord injury. These can help to identify a patient who may benefit from more aggressive management. The authors are from the VA Boston Healthcare System, Harvard Medical School, Massachusetts General Hospital and Brigham and Women’s Hospital.


Chest illness was defined as any chest disorder that kept the patient from usual activities (kept from work, stayed indoors at home, stayed in bed).


Patient selection: VA patient 1 or more years after SCI. Excluded if: history of polio, multiple sclerosis, ventilator dependent, tracheostomy, stroke, lung resection


Predictors for “chest illness”:

(1) smoking

(2) any wheeze

(3) any episode of pneumonia or bronchitis since the spinal cord injury

(4) chronic obstructive lung disease (COPD)


An FEV1 less than predicted was associated with an increased risk for chest illness (1.2% increase in risk for each 1% decrease from predicted).



• The precise conditions (bronchitis, pneumonia, asthma, etc) causing the chest illness were not quantified.


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