Abstract:ObjectiveTo explore the risk factors of tracheotomy in patients with traumatic cervical spinal cord injury(TCSCI)and the predictive value of related scoring system. Methods A total of 189 TCSCI patients over 18 years old admitted to hospital from July 2012 to February 2018 were selected and analyzed retrospectively.According to whether or not tracheotomy was performed,the patients were divided into tracheotomy group(n=86) and non-tracheotomy group(n=103).Univariate and multivariate logistic regression analysis were used to analyze the risk factors for tracheotomy.The receive operating characteristic(ROC) curve was drawn to evaluate the predictive values of American Spinal Injury Association (ASIA) score of motion and sensation,Acute Physiology and Chronic Health Enquiry Ⅱ (APACHE-Ⅱ) score,Injury Severity Score(ISS) and Clinical Pulmonary Infection Score(CPIS) for tracheotomy. Results (1) There were significant differences in long-term smoking history,chronic lung disease history,spinal cord injury level and degree,tracheal intubation,pulmonary infection,ASIA motor and sensation,APACHE Ⅱ,ISS,CPIS scores between two groups (all P<0.01),and long-term smoking history,chronic lung disease history,spinal cord injury with high level and severe degree,tracheal intubation,pulmonary infection,were the independent risk factors for tracheotomy (P<0.05).(2)The longer the history of long-term smoking and chronic lung disease,the heavier the spinal cord injury degree and the higher the spinal cord injury level,the earlier the time for tracheotomy.The time for tracheotomy in patients combined with pulmonary infection was later than that in patients without pulmonary infection (P<0.05).(3)ROC curve plotting showed that ASIA motor scoring system revealed the largest area under curve (AUC,0.995),the highest sensitivity (0.988) and the higher specificity (0.961) in prognostic need for tracheotomy. Conclusion There areunique risk factors of tracheotomy for patients with traumatic cervical spinal cord injury.The reasonable analysis and effective prediction can reduce unreasonable and delayed tracheotomy and prevent the occurrence of pulmonary infection.