Spinal cord injury trends in the United States, 1972–2017

Abstract

This cross-sectional analysis of longitudinal data was conducted to document demographic and clinical characteristics of newly injured and prevalent population with spinal cord injury (SCI) in the United States. 32.727 people with traumatic SCI who received initial hospital care from one of the 30 SCI Model Systems Centers since the early 1970s were included in the analyses with data on demographic, injury and medical characteristics, and psychosocial wellbeing obtained during the initial hospitalization and at year 1, 5, and every 5 years after injury through 2017. Age at injury has increased from 29 years in the 1970s to 42 years currently. This aging phenomenon was noted for all sexes, races, and etiologies except acts of violence. Although vehicular crashes continue to be the leading cause of SCI overall, injuries due to falls have increased over time particularly among those aged 46 years and older. Injuries resulting in tetraplegia are increasing while neurologically complete injuries are decreasing. Lengths of stay in the acute hospital and rehabilitation unit have declined. About 30% of persons with SCI are re-hospitalized during any given year following injury. Diseases of the genitourinary system are the leading cause of re-hospitalization. Mortality rates are significantly higher during the first year after injury. The life expectancy has improved but remain significantly below life expectancies of persons without SCI. The causes of death that have the greatest impact on reduced life expectancy over the last 5 decades are pneumonia and septicemia. Study findings call for geriatrics expertise in the care for SCI and also highlights the need for a multi-dimensional risk assessment and intervention to reduce falls and SCI in older adults. Within the prevalent population, those who survive many years typically will have less severe injuries, high levels of independence and overall good health.