Penetrating Spinal Cord Injury in civilians: analysis of a national database

Document Type

Article

Abstract

BACKGROUND: Spinal trauma is common in polytrauma; spinal cord injury (SCI) is present in a subset of these patients. Penetrating SCI has been studied in the military; however, civilian SCI is less studied. Civilian injury pathophysiology varies given the generally lower velocity of the projectiles. We sought to investigate civilian penetrating SCI in the United States. METHODS: We queried the National Inpatient Sample for data regarding penetrating spinal cord injury from the past 10 years (2006-2015). The National Inpatient Sample includes data of 20% of discharged patients from U.S. hospitals. We analyzed trends of penetrating SCI regarding its diagnosis, demographics, surgical management, length of stay, and hospital costs. RESULTS: In the past 10 years the incidence of penetrating SCI in all SCI patients has remained stable with a mean of 5.5% (range 4.3%-6.6%). Of the patients with penetrating SCI, only 17% of them underwent a surgical procedure, compared with 55% for nonpenetrating SCI. Patients with penetrating SCI had a longer length of stay (average 23 days) compared with nonpenetrating SCI (15 days). Hospital charges were higher for penetrating SCI: $230,186 compared with $192,022 for closed SCI. Males patients were more affected by penetrating SCI, as well as black and Hispanic populations compared with whites. CONCLUSIONS: Penetrating SCI represents 5.5% of all SCI patients. Men, blacks, and Hispanics are disproportionally more affected by penetrating SCI. Patients with penetrating SCI have fewer surgical interventions, but their overall length of stay and hospital costs are greater compared with nonpenetrating SCI.

Medical Subject Headings

Adolescent; Adult; Black or African American (statistics & numerical data); Aged; Aged, 80 and over; Case-Control Studies; Databases, Factual; Female; Hispanic or Latino (statistics & numerical data); Hospital Charges (statistics & numerical data); Humans; Laminectomy (statistics & numerical data); Length of Stay (economics, statistics & numerical data); Male; Middle Aged; Neurosurgical Procedures (economics, statistics & numerical data); Sex Distribution; Spinal Cord Injuries (economics, epidemiology, therapy); Spinal Fusion (statistics & numerical data); United States (epidemiology); White People (statistics & numerical data); Wounds, Nonpenetrating (economics, epidemiology, therapy); Wounds, Penetrating (economics, epidemiology, therapy); Young Adult

Publication Date

2-1-2021

Publication Title

World neurosurgery

E-ISSN

1878-8769

Volume

146

First Page

e985

Last Page

e992

PubMed ID

33220486

Digital Object Identifier (DOI)

10.1016/j.wneu.2020.11.059

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