Traumatic spinal injury-related hospitalizations in the United States, 2016–2019: a retrospective study

International Journal of Surgery, 2023 · DOI: http://dx.doi.org/10.1097/JS9.0000000000000696 · Published: September 2, 2023

Spinal Cord Injury Trauma Public Health

Simple Explanation

This study examines traumatic spinal injuries (TSIs) in the United States from 2016 to 2019 using a large inpatient database. TSIs include fractures, dislocations, and spinal cord injuries. The study found that the incidence of TSIs increased slightly over the study period, with a notable rise in spinal cord injuries (SCIs). The research also compared surgical and non-surgical treatments, finding surgical treatment more common and associated with lower in-hospital mortality.

Study Duration

4 Years

Participants

95 047 adult patients hospitalized with TSI

Evidence Level

Cross-Sectional Study

Key Findings

1
The estimated overall incidence of TSI was 48.4 per 100 000 persons in 2019.
2
The incidence of SCIs-related hospitalizations increased (APC, 9.9%; 95% CI: 1.4–19.2%).
3
Inpatient mortality in the operative treatment group was highest among SCI-related hospitalizations (3.9%; 95% CI: 2.9–5%).

Research Summary

The study evaluated national trends in TSI incidence and treatment in the US from 2016 to 2019, describing demographic and clinical characteristics of TSI-related hospitalizations as seen in 2019. A trend of increased TSI-related hospitalizations and SCI-related hospitalizations was observed. SCI was the most severe TSI type, associated with the highest LOS, cost, and mortality, regardless of treatment.

Practical Implications

Policy Implications

The increase in SCI-related hospitalizations indicates a need for more policy efforts to prevent such injuries.

Clinical Guidelines

The increasing proportion of operations for SCI-related hospitalizations may indicate successful implementation of clinical guidelines recommending early operations.

Future Research

Given the lack of high-quality evidence supporting nonoperative treatment of TSI, more research is needed to provide a reference for the management of nonoperative treatment for TSI-related hospitalizations.

Study Limitations

1
The 2012 redesign of the NIS excluded long-term care hospitals, which primarily affected the statistics related to elderly patients.
2
The modification of race not only excluded the race classification of ʻOther Raceʼ but reassigned this population to other OMB race categories.
3
Due to limited data availability, the trend analysis covers only 4 years, potentially affecting the robustness of the acquired APC values.

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