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Factors Associated with in-hospital outcomes of traumatic spinal cord injury: A 10-year analysis of the US National Inpatient Sample.

Spinal cord injuries (SCI) can be life-changing events, often leading to motor and sensory loss and permanent disability. The most common causes of SCI are motor vehicle accidents (comprising 39.2% of injuries) and falls (28.3%). Falls are particularly prevalent along elderly patients, who tend to have compromised balance and weaker joints, increasing their risk of dangerous falls. Additionally, this vulnerable group is at elevated risk for poor outcomes after SCI, including care-related complications and higher mortality rates during hospitalization.

Although older age is a well-known risk factor for falls, researchers must continually update their data on outcomes among elderly populations to reflect the rapidly shifting demographic makeup of the United States, where the elderly population is expected to double by 2050. To add to this knowledge base, a research team used the United States National Impact Sample database to gather health data from 25,988 SCI patients hospitalized between 2005 to 2014. They analyzed rates of in-hospital deaths, prolonged hospital stay, and adverse outcomes after discharge across all ages and injury sites.

The study found that patients over the age of 65 were at more than five times the risk of in-hospital deaths, and more than twice at risk of adverse outcomes post discharge as compared to patients under 35. This was true regardless of injury site, which was a factor that mattered much more in patients aged 35 to 64. Cervical SCI, which occurs at the top of the spine and is the area most commonly injured by falling, was the most common across all groups, but most especially among older patients.

Because the risk of complications grows exponentially as a person ages, extra vigilance is needed when treating older SCI patients. Better management strategies should also be developed to provide better care during hospitalization as well, to reduce the severity of age-related risks. As the elderly population continues to expand in the United States, health care professionals should prepare to treat a large influx of high-risk SCI patients.

Gao F, Chu H, Chen L, et al. Factors Associated with In-Hospital Outcomes of Traumatic Spinal Cord Injury: 10-year Analysis of the US National Inpatient Sample. Journal of the American Academy of Orthopaedic Surgeons. (September 2020).

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