Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2015 Jun 9;313(22):2236-43.
doi: 10.1001/jama.2015.6250.

Traumatic spinal cord injury in the United States, 1993-2012

Nitin B Jain  1 , Gregory D Ayers  2 , Emily N Peterson  2 , Mitchel B Harris  3 , Leslie Morse  4 , Kevin C O'Connor  5 , Eric Garshick  6
Affiliations

Traumatic spinal cord injury in the United States, 1993-2012

Nitin B Jain et al. JAMA. .

Abstract

Importance: Acute traumatic spinal cord injury results in disability and use of health care resources, yet data on contemporary national trends of traumatic spinal cord injury incidence and etiology are limited.

Objective: To assess trends in acute traumatic spinal cord injury incidence, etiology, mortality, and associated surgical procedures in the United States from 1993 to 2012.

Design, setting, and participants: Analysis of survey data from the US Nationwide Inpatient Sample databases for 1993-2012, including a total of 63,109 patients with acute traumatic spinal cord injury.

Main outcomes and measures: Age- and sex-stratified incidence of acute traumatic spinal cord injury; trends in etiology and in-hospital mortality of acute traumatic spinal cord injury.

Results: In 1993, the estimated incidence of acute spinal cord injury was 53 cases (95% CI, 52-54 cases) per 1 million persons based on 2659 actual cases. In 2012, the estimated incidence was 54 cases (95% CI, 53-55 cases) per 1 million population based on 3393 cases (average annual percentage change, 0.2%; 95% CI, -0.5% to 0.9%). Incidence rates among the younger male population declined from 1993 to 2012: for age 16 to 24 years, from 144 cases/million (2405 cases) to 87 cases/million (1770 cases) (average annual percentage change, -2.5%; 95% CI, -3.3% to -1.8%); for age 25 to 44 years, from 96 cases/million (3959 cases) to 71 cases/million persons (2930 cases), (average annual percentage change, -1.2%; 95% CI, -2.1% to -0.3%). A high rate of increase was observed in men aged 65 to 74 years (from 84 cases/million in 1993 [695 cases] to 131 cases/million [1465 cases]; average annual percentage change, 2.7%; 95% CI, 2.0%-3.5%). The percentage of spinal cord injury associated with falls increased significantly from 28% (95% CI, 26%-30%) in 1997-2000 to 66% (95% CI, 64%-68%) in 2010-2012 in those aged 65 years or older (P < .001). Although overall in-hospital mortality increased from 6.6% (95% CI, 6.1%-7.0%) in 1993-1996 to 7.5% (95% CI, 7.0%-8.0%) in 2010-2012 (P < .001), mortality decreased significantly from 24.2% (95% CI, 19.7%-28.7%) in 1993-1996 to 20.1% (95% CI, 17.0%-23.2%) in 2010-2012 (P = .003) among persons aged 85 years or older.

Conclusions and relevance: Between 1993 and 2012, the incidence rate of acute traumatic spinal cord injury remained relatively stable but, reflecting an increasing population, the total number of cases increased. The largest increase in incidence was observed in older patients, largely associated with an increase in falls, and in-hospital mortality remained high, especially among elderly persons.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Temporal Trends in Acute Traumatic Spinal Cord Injury Incidence Rate per 1 Million Persons in the United States, 1993–2012
Figure 2
Figure 2
Trends in Etiology of Acute Traumatic Spinal Cord Injury in the United States
See this image and copyright information in PMC

Comment in

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. National Spinal Cord Injury Statistical Center Spinal cord injury facts and figures at a glance. J Spinal Cord Med. 2013;36(1):1–2. - PMC - PubMed
    1. A comprehensive plan for spinal cord injury services in Pennsylvania. Pa Med. 1978;81(5):29–38. 43–54. - PubMed
    1. Bracken MB, Freeman DH, Jr, Hellenbrand K. Incidence of acute traumatic hospitalized spinal cord injury in the United States, 1970–1977. Am J Epidemiol. 1981;113(6):615–622. - PubMed
    1. DeVivo MJ, Fine PR, Maetz HM, Stover SL. Prevalence of spinal cord injury: a reestimation employing life table techniques. Arch Neurol. 1980;37(11):707–708. - PubMed
    1. Griffin MR, O'Fallon WM, Opitz JL, Kurland LT. Mortality, survival and prevalence: traumatic spinal cord injury in Olmsted County, Minnesota, 1935–1981. J Chronic Dis. 1985;38(8):643–653. - PubMed

Publication types

MeSH terms