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. 2023 Dec 1;109(12):3827-3835.
doi: 10.1097/JS9.0000000000000696.

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

Jiuxiao Sun  1 , Wenjian Yuan  1 , Ruiyuan Zheng  1 , Chi Zhang  1 , Bin Guan  1 , Jiaming Ding  1 , Zhuo Chen  1 , Qingyu Sun  1 , Runhan Fu  1 , Lingxiao Chen  1   2 , Hengxing Zhou  1   3 , Shiqing Feng  1   3
Affiliations

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

Jiuxiao Sun et al. Int J Surg. .

Abstract

Background: Traumatic spinal injury (TSI) is associated with significant fatality and social burden; however, the epidemiology and treatment of patients with TSI in the US remain unclear.

Materials and methods: An adult population was selected from the National Inpatient Sample database from 2016 to 2019. TSI incidence was calculated and TSI-related hospitalizations were divided into operative and nonoperative groups according to the treatments received. TSIs were classified as fracture, dislocation, internal organ injury, nerve root injury, or sprain injuries based on their nature. The annual percentage change (APC) was calculated to identify trends. In-hospital deaths were utilized to evaluate the prognosis of different TSIs.

Results: Overall, 95 047 adult patients were hospitalized with TSI in the US from 2016 to 2019, with an incidence rate of 48.4 per 100 000 persons in 2019 (95% CI: 46.2-50.6). The total incidence increased with an APC of 1.5% (95% CI: 0.1-3%) from 2016 to 2019. Operative TSI treatment was more common than nonoperative (32.8 vs. 3.8; 95% CI: 32.3-33.2 vs. 3.6-4%). The number of operations increased from 37 555 (95% CI: 34 674-40 436) to 40 460 (95% CI: 37 372-43 548); however, the operative rate only increased for internal organ injury (i.e. spinal cord injury [SCI])-related hospitalizations (APC, 3.6%; 95% CI: 2.8-4.4%). In-hospital mortality was highest among SCI-related hospitalizations, recorded at 3.9% (95% CI: 2.9-5%) and 28% (95% CI: 17.9-38.2%) in the operative and nonoperative groups, respectively.

Conclusions: The estimated incidence of TSI in US adults increased from 2016 to 2019. The number of operations increased; however, the proportion of operations performed on TSI-related hospitalizations did not significantly change. In 2019, SCI was the highest associated mortality TSI, regardless of operative or nonoperative treatment.

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Conflict of interest statement

The authors declare that they have no conflicts of interest.

Figures

Figure 1
Figure 1
Flowchart of extracting traumatic spinal injury-related hospitalizations data from National Inpatient Sample.
Figure 2
Figure 2
Trends of the proportion of operative treatments among traumatic spinal injury-related hospitalizations, 2016–2019 (* Indicates that the Annual Percentage Change is significantly different from zero at the alpha=0.05 level).
See this image and copyright information in PMC

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