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Race and insurance status may correlate with pediatric spine injury outcomes
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According to the results of a recently published study, race, age, and insurance status correlated with the mechanism, management and outcomes of spinal cord injuries in pediatric patients.
Researchers identified admissions for spinal fracture with or without spinal cord injury (SCI), dislocation, and SCI without radiographic abnormality using the Kids’ Inpatient Database and National Trauma Data Bank (NTDB) for 2009. Insurance types were noted and grouped into either commercial, other or Medicaid/self-pay/no charge categories.
Researchers noted race and economics had a strong association with the mechanism and severity of injury. About 23.9% of black patients with a spinal injury were admitted for gunshot wounds, compared with 1% of white patients. In addition, black patients tended to have more severe injuries than patients of other races as measured by Injury Severity Scale scores. Investigators also found patients with less insurance from poorer neighborhoods tended to have more injuries from firearms and abuse.
In the NTDB, Medicaid/self-pay/no charge patients presented with the highest SCI rates at 13.7%, followed by commercial insurance at 12.7% and other insurance at 9.9%, according to researchers. The overall mortality rate in the NTDB was 3.9%, but in a multivariate analysis including a panel of clinical and nonclinical factors, black race was found to be a statistically significant predictor of mortality. Using the NTDB, investigators also noted race and payor status were linked with spinal fusion rates. According to the researchers, spinal fusion rates were higher in patients with better insurance. – by Robert Linnehan.
Disclosures: The researchers report no relevant financial disclosures.
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