The Epidemiology of Childhood and Adolescent Traumatic Spinal Cord Injury in the United States: 2007–2010

Journal of neurotrauma (Impact Factor: 3.71). 05/2014; 31(18). DOI: 10.1089/neu.2014.3332
Source: PubMed


The burden of acute traumatic spinal cord injury (TSCI) among United States (U.S.) children and adolescents was last described over a decade ago using inpatient data. We describe cumulative incidence, mortality, discharge disposition, and inflation-adjusted charges of childhood and adolescent TSCI in the U.S. using emergency department (ED) data from the Nationwide Emergency Department Sample (2007-2010). Patients aged ≤17 years with a diagnosis of acute TSCI were identified using ICD-9 diagnosis codes 806.* and 952.* (N=6,132). The cumulative incidence of childhood and adolescent TSCI averaged 17.5 per million-population. The median age at presentation was 15 years (interquartile range [IQR]=12-16), with majority being males (72.5%). The overall median injury severity score (NISS) was 16 (IQR=9-27), remaining unchanged during the study duration (P=0.703). Children ≤5 years were more likely to be injured from a road traffic accident (RTA) (50.9%), present with C1-C4 injuries (47.4%), have higher NISS (22, IQR=13-29), and concurrent brain injury (24%) compared to older children and adolescents, P<0.001. Firearms were implicated in 8.3% of injuries, of which 94.7% were among adolescents aged 13-17 years. Of the 35 TSCI-related ED deaths, 40% occurred among children ≤5 years. Inpatient admission occurred for 62.4% of patients. Despite stable cumulative incidence and overall injury severity, ED treatment charge per visit increased on average $1,394 from $3,495 in 2007 to $4,889 in 2010 (P<0.008). RTA-related TSCI disproportionately affects young children, while firearm-related TSCI is most common among adolescents. These findings inform TSCI prevention strategies. Prevention may be key in mitigating rising healthcare cost. Keywords: epidemiology, traumatic spinal cord injury, burden, children, adolescents, Nationwide Emergency Department Sample.

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Available from: Shalini Selvarajah, Oct 01, 2014
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