Between 1993 and 2012, the incidence rate of acute traumatic spinal cord injury remained relatively stable in the USA, although there was an increase among older adults, mostly associated with an increase in falls, according to a study in JAMA.
Despite the substantial effects of traumatic spinal cord injury on health-related quality of life and health care spending, contemporary data on trends in incidence, causes, and medical care are limited, according to the article.
Nitin B Jain, of the Vanderbilt University School of Medicine, Nashville, USA, and colleagues analysed survey data from the US Nationwide Inpatient Sample databases for 1993–2012 to examine trends in incidence, causes, health care utilisation, and mortality for acute traumatic spinal cord injury.
The total study sample consisted of 63,109 patients with acute traumatic spinal cord injury. The actual number of cases in the database increased from 2,659 in 1993 to 3,393 in 2012. The incidence rate for acute traumatic spinal cord injury remained relatively stable: the estimated rate was 53 cases per 1 million persons in 1993 and 54 cases per 1 million persons in 2012.
Incidence rates among the younger male population declined. For both the male and female populations, a high rate of increase in spinal cord injury incidence from 1993 to 2012 was observed in elderly persons. Although overall in-hospital mortality increased from 6.6% in 1993–1996 to 7.5% in 2010-2012, mortality decreased significantly from 24% in 1993–1996 to 20% in 2010–2012 among persons 85 years or older.
The percentage of spinal cord injury associated with falls increased significantly from 28% in 1997–2000 to 66% in 2010–2012 in those 65 years or older. “This is a major public health issue and it likely represents a more active 65- to 84-year-old US population currently compared with the 1990s, which increases the risk of falls in this age group. This issue may be further compounded in the future because of the aging population in the USA,” the authors write.