Number of traumatic spinal cord injuries increase in US

The incidence of traumatic spinal cord injury has increased among older adults, who also experience worse outcomes compared with younger adults, according to a recently published study.

Perspective from Lesley M. Hudson, MA

Researchers from Johns Hopkins analyzed a nationally representative sample of 43,137 adults treated in hospital emergency rooms for spinal cord injury in the United States between 2007 and 2009. Overall, the researchers found that the cumulative incidence of traumatic spinal cord injury increased from 79.4 million older adults in 2007 to 87.7 by the end of 2009. However, among younger adults, the incidence of traumatic spinal cord injury remained steady. Researchers found 41.5% of traumatic spinal cord injuries were caused by falls, followed by motor vehicle crashes at 35.5%. During the study period, emergency department charges increased by 20% and death occurred in 5.7% of patients, with older adults having higher adjusted odds of mortality in the emergency department, mortality during hospitalization and discharge to chronic care compared to younger adults.

“We have demonstrated how costly traumatic spinal cord injury is and how lethal and disabling it can be among older people. It is an area that is ripe for prevention,” Shalini Selvarajah, MD, MPH, a postdoctoral surgical research fellow at the Johns Hopkins University School of Medicine, stated in a press release. “With so much emphasis on trying to reduce health care costs right now, this is another reason why preventing the injury altogether is so vital.”

Reference:

Selvarajah S. J Neurotrauma. 2014;doi:10.1089/neu.2013.3098.
Disclosure: The researchers have no relevant financial disclosures.

Perspective

Lesley M. Hudson, MA

Since the early 1970s when reliable statistics on the incidence and prevalence of spinal cord injuries (SCIs) began to be collected, motor vehicle accidents (MVAs) have been their number one cause. Other etiologies have shifted over time, and presently, falls are creeping up. MVAs, in my opinion, will always be first because of the number of automobiles on the roads, the increasing speeds at which they can travel legally and the continuing tendency, largely in the youthful driver, to engage in the risky behavior of any manner of distracted driving (alcohol, texting, etc.).

That having been said, however, it is the prevailing opinion among experts in the SCI field that in recent years, a “bubble” of falls has emerged, especially among older adults. This is largely felt to be secondary to longer life spans, increased physical leisure pursuits (“65 is the new 35”) and an engagement among the leading edge Baby Boomers in somewhat “riskier” behavior. As a consequence of this “bubble,” large SCI rehabilitation facilities have established senior treatment teams to care for older patients who are newly injured. This population requires an attention not only to the SCI, but also to all chronic conditions that patients have by virtue of their age. This phenomenon will continue to be monitored over time, and prevention and care delivery options should be adjusted accordingly.

Lesley M. Hudson, MA

Project Director of the Spinal Cord

Injury Model System

Shepherd Center

Atlanta

Disclosures: Hudson has no relevant financial disclosures.