Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 May;19(5):1126-1133.
doi: 10.4103/1673-5374.382257.

Epidemiological and clinical features, treatment status, and economic burden of traumatic spinal cord injury in China: a hospital-based retrospective study

Hengxing Zhou  1 , Yongfu Lou  2 , Lingxiao Chen  3 , Yi Kang  4 , Lu Liu  5 , Zhiwei Cai  6 , David B Anderson  7 , Wei Wang  8 , Chi Zhang  8 , Jinghua Wang  9 , Guangzhi Ning  4 , Yanzheng Gao  10 , Baorong He  5 , Wenyuan Ding  11 , Yisheng Wang  12 , Wei Mei  13 , Yueming Song  14 , Yue Zhou  15 , Maosheng Xia  16 , Huan Wang  17 , Jie Zhao  18 , Guoyong Yin  19 , Tao Zhang  20 , Feng Jing  21 , Rusen Zhu  22 , Bin Meng  23 , Li Duan  24 , Zhongmin Zhang  25 , Desheng Wu  26 , Zhengdong Cai  27 , Lin Huang  28 , Zhanhai Yin  29 , Kainan Li  30 , Shibao Lu  31 , Shiqing Feng  32
Affiliations

Epidemiological and clinical features, treatment status, and economic burden of traumatic spinal cord injury in China: a hospital-based retrospective study

Hengxing Zhou et al. Neural Regen Res. 2024 May.

Abstract

Traumatic spinal cord injury is potentially catastrophic and can lead to permanent disability or even death. China has the largest population of patients with traumatic spinal cord injury. Previous studies of traumatic spinal cord injury in China have mostly been regional in scope; national-level studies have been rare. To the best of our knowledge, no national-level study of treatment status and economic burden has been performed. This retrospective study aimed to examine the epidemiological and clinical features, treatment status, and economic burden of traumatic spinal cord injury in China at the national level. We included 13,465 traumatic spinal cord injury patients who were injured between January 2013 and December 2018 and treated in 30 hospitals in 11 provinces/municipalities representing all geographical divisions of China. Patient epidemiological and clinical features, treatment status, and total and daily costs were recorded. Trends in the percentage of traumatic spinal cord injuries among all hospitalized patients and among patients hospitalized in the orthopedic department and cost of care were assessed by annual percentage change using the Joinpoint Regression Program. The percentage of traumatic spinal cord injuries among all hospitalized patients and among patients hospitalized in the orthopedic department did not significantly change overall (annual percentage change, -0.5% and 2.1%, respectively). A total of 10,053 (74.7%) patients underwent surgery. Only 2.8% of patients who underwent surgery did so within 24 hours of injury. A total of 2005 (14.9%) patients were treated with high-dose (≥ 500 mg) methylprednisolone sodium succinate/methylprednisolone (MPSS/MP); 615 (4.6%) received it within 8 hours. The total cost for acute traumatic spinal cord injury decreased over the study period (-4.7%), while daily cost did not significantly change (1.0% increase). Our findings indicate that public health initiatives should aim at improving hospitals' ability to complete early surgery within 24 hours, which is associated with improved sensorimotor recovery, increasing the awareness rate of clinical guidelines related to high-dose MPSS/MP to reduce the use of the treatment with insufficient evidence.

Keywords: China; clinical features; costs; epidemiology; methylprednisolone; methylprednisolone sodium succinate; retrospective study; traumatic spinal cord injury; treatment.

PubMed Disclaimer

Conflict of interest statement

None

Figures

Figure 1
Figure 1
Study flow chart. EXCL: Excluded; MP: methylprednisolone; MPSS: methylprednisolone sodium succinate; TSCI: traumatic spinal cord injury.
Figure 2
Figure 2
Trends in the percentage of traumatic spinal cord injuries among all hospitalized patients (A) and among patients hospitalized in the orthopedic department (B) in 20 hospitals from 2013 to 2018. APC: Annual percentage change; CI: confidence interval.
Figure 3
Figure 3
Use of methylprednisolone sodium succinate (MPSS)/methylprednisolone (MP) among traumatic spinal cord injury patients during hospitalization. (A) High-dose MPSS/MP (≥ 500 mg). (B) Continuous normal-dose MPSS/MP (< 500 mg). (C) Intermittent normal-dose.
See this image and copyright information in PMC

References

    1. Abbas A, Aziz HF, Rizvi R, Rehaman L, Javeed F, Afzal A. Gunshot acquired spinal cord injury in civilians. Turk Neurosurg. (2019);29:506–512. - PubMed
    1. Ahuja CS, Wilson JR, Nori S, Kotter MRN, Druschel C, Curt A, Fehlings MG. Traumatic spinal cord injury. Nat Rev Dis Primers. (2017);3:17018. - PubMed
    1. Arnold PM, Anderson PA, Chi JH, Dailey AT, Dhall SS, Eichholz KM, Harrop JS, Hoh DJ, Qureshi S, Rabb CH, Raksin PB, Kaiser MG, O'Toole JE. Congress of neurological surgeons systematic review and evidence-based guidelines on the evaluation and treatment of patients with thoracolumbar spine trauma:pharmacological treatment. Neurosurgery. (2019);84:E36–38. - PubMed
    1. Badhiwala JH, Wilson JR, Fehlings MG. Global burden of traumatic brain and spinal cord injury. Lancet Neurol. (2019);18:24–25. - PubMed
    1. Badhiwala JH, Wilson JR, Witiw CD, Harrop JS, Vaccaro AR, Aarabi B, Grossman RG, Geisler FH, Fehlings MG. The influence of timing of surgical decompression for acute spinal cord injury:a pooled analysis of individual patient data. Lancet Neurol. (2021);20:117–126. - PubMed