Trends of traumatic spinal injury-related hospitalizations in Australian children over a 10-year period: a nationwide population-based cohort study

Abstract

Background context: Despite its potential to cause serious and life-long disability or death, population-based data on traumatic spinal injury in pediatric populations is scarce.

Purpose: To quantify and describe the incidence and cost of hospitalizations for traumatic spinal injury among Australian children, and to examine the trend over a 10-year period.

Study design: Population-based retrospective cohort study.

Patient sample: Children aged ≤16 years who were hospitalized for traumatic spinal injury in Australia during 1 July 2002 to 30 June 2012.

Outcome measures: Age-standardized hospital admission rates.

Methods: This study used linked hospitalization and mortality data. Age-standardized hospitalization rates were calculated with 95% confidence intervals (CIs). Negative binomial regression was used to examine change in temporal trends in hospitalization rates.

Results: There were 4,360 hospitalizations for pediatric traumatic spinal injury during the 10-year study period. Males and older children were more frequently hospitalized, and falls and road trauma accounted for almost three-quarters of hospitalizations. The average overall annual hospitalization rate was 9.43 (95% CI: 9.15-9.72) per 100,000 population, with an annual percent change of 1.2% (95% CI: -0.1% to 2.4%). There was an increase in the annual hospitalization rate for spinal dislocations, sprains, and strains (3.0% [95% CI: 0.8%-5.3%]) and among female children (1.7% [95% CI: 0.0%-3.4%]). The estimated total hospital treatment costs were AUD$43 million over the 10-year study period, with an estimated mean cost per child of AUD$9,867.

Conclusions: Pediatric traumatic spinal injury is associated with significant morbidity and mortality. The burden of hospitalized pediatric traumatic spinal injury in Australia is rising, in particular spinal dislocations, sprains, and strains among female children. Targeted prevention strategies are needed to reduce the burden of pediatric traumatic spinal injury. It is recommended that a coordinated national strategy for preventing childhood traumatic spinal injury is developed and implemented in Australia.

Keywords: Data linkage; Epidemiology; Injury prevention; Pediatric; Spinal injury.