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Citation |
Selvarajah S, Schneider EB, Becker D, Sadowsky C, Haider AH, Hammond ER. J. Neurotrauma 2014; 31(18): 1548-1560. |
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Affiliation |
Johns Hopkins University School of Medicine, Surgery, 600 North Wolfe Street, Blalock 611, Baltimore, Maryland, United States, 21287, 410-614-7182, 410-955-8101 ; sselvar2@jhmi.edu. |
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Copyright |
(Copyright © 2014, Mary Ann Liebert Publishers) |
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DOI |
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PMID |
24811704 |
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Abstract |
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. Language: en |