A population-based study comparing traumatic spinal cord injury and non-traumatic spinal cord injury using a national rehabilitation database

Abstract

Study design: A limitation of many studies of non-traumatic spinal cord injury (NT-SCI) and traumatic spinal cord injury (T-SCI) is potential lack of generalizability because of selection bias. An open cohort study using a national rehabilitation database was planned to address this.

Objective: To compare the demographic characteristics and outcomes between NT-SCI and T-SCI patients.

Setting: Rehabilitation hospitals in Australia.

Methods: The Australasian Rehabilitation Outcomes Centre maintains a national database of information on in-patients admitted to almost all (130/145 as at 2006) public and private rehabilitation hospitals in Australia. It collects a range of demographic and clinical outcomes. Patients were included if they were discharged between 1 January 2002 and 31 December 2006. Patients were excluded if they were admitted for <7 days, only for assessment or were a readmission.

Results: There were 3610 patients included (NT-SCI, n=2241, 62.1%; T-SCI, n=1361, 37.7%). There were numerous significant differences between NT-SCI and T-SCI patients. NT-SCI patients were generally older (median age NT-SCI 67 years vs T-SCI 46 years, P=0.000), less likely to be male (male NT-SCI 52.5% vs T-SCI 71.6%, P=0.000) and had a shorter length of stay (median NT-SCI 21 days vs T-SCI 44 days, P=0.000). NT-SCI patients were also less disabled than T-SCI patients, having higher Functional Independence Measure motor subscale score on admission (median NT-SCI 53 vs T-SCI 38, P=0.000) and discharge (median NT-SCI 76 vs T-SCI 74, P=0.000).

Conclusion: Previous demographic studies of NT-SCI and T-SCI patients are similar to our population-based results. More population-based research in SCI is required.