Dual diagnosis: the prevalence of brain injury and spinal cord injury in the pediatric population and its impact on length of stay

Abstract

Objective: To determine the prevalence of pediatric patients with dual diagnosis of traumatic brain injury and spinal cord injury (DDS) to patients diagnosed with spinal cord injury (SCI) and to determine how the presence of a brain injury affects rehabilitation outcomes and length of stay. Design: A 9-year retrospective chart review of patients with pediatric spinal cord injury admitted for inpatient rehabilitation was completed. Setting: A 28- bed Pediatric Inpatient Rehabilitation Unit of a tertiary care regional referral center. Participants: 212 pediatric patients, ranging from 0 to 21 years of age who sustained a traumatic or non-traumatic spinal cord injury requiring admission to acute rehabilitation between January 2008 and December 2017. Interventions: N/A Results: The mean age of the population was 9.9 years at the time of admission. The average length of time from the injury to admission was 20.4 days. This patient population was 54% male and 46% female. Overall, 31.6% of children with SCI had concomitant brain injury, with 50% of children with traumatic SCI sustaining a brain injury. The length of stay was 25.9 days for patients with SCI alone; however, it was 38.2 days for children with DDS. Conclusion: The incidence of DDS in the traumatic pediatric spinal cord injury population is relatively common and appropriate screenings should be anticipated. Patients with DDS have the potential to achieve similar functional gains as SCI patients without brain injuries but appropriate adjustments should be made to their plans of care, including adjusting expected length of hospital stay.