Direct Cost of Illness for Spinal Cord Injury: A Systematic Review

Abstract

Study Design: Systematic review. Objective: Providing a comprehensive review of spinal cord injury cost of illness studies to assist health-service planning. Methods: We conducted a systematic review of the literature published from Jan. 1990 to Nov. 2020 via Pubmed, EMBASE, and NHS Economic Evaluation Database. Our primary outcomes were overall direct health care costs of SCI during acute care, inpatient rehabilitation, within the first year post-injury, and in the ensuing years. Results: Through a 2-phase screening process by independent reviewers, 30 articles out of 6177 identified citations were included. Cost of care varied widely with the mean cost of acute care ranging from $290 to $612,590; inpatient rehabilitation from $19,360 to $443,040; the first year after injury from $32,240 to $1,156,400; and the ensuing years from $4,490 to $251,450. Variations in reported costs were primarily due to neurological level of injury, study location, methodological heterogeneities, cost definitions, study populations, and timeframes. A cervical level of the injury, ASIA grade A and B, concomitant injuries, and in-hospital complications were associated with the greatest incremental effect in cost burden. Conclusion: The economic burden of SCI is generally high and cost figures are broadly higher for developed countries. As studies were only available in few countries, the generalizability of the cost estimates to a regional or global level is only limited to countries with similar economic status and health systems. Further investigations with standardized methodologies are required to fill the knowledge gaps in the healthcare economics of SCI.

Moonlighting chromatin: when DNA escapes nuclear control

“…In a first assessment of the neutrophil proteome, a total of 251 major cellular proteins in different compartments were identified by gel-LC-MS/MS [ 88 ]. This proteome included the azurophilic granule proteins NE and MPO as well as PAD4, which catalyzes the deimination of arginine to citrulline and mediates chromatin decondensation [ 89 , 90 , 55 ]. In a recent proteome analysis by Petretto et al, 330 NET-associated proteins were identified; many with posttranslational modifications [ 91 ].…”

“…Traumatic spinal cord injury (tSCI) can result in permanent paralysis of patients. Beside individual sequelae and psychosocial trauma, the socioeconomic burden is substantial [ 89 ]. A recent multicenter cohort study showed that tSCI patients are among the most resource intense patient group of $11.193 per admission in Canada [ 247 ].…”

Research Progress of MicroRNAs in Spinal Cord Injury

“…Many studies have also shown that SCI patients are more likely to suffer from depression or anxiety than normal people [5][6][7]. Additionally, the financial cost per SCI patient is generally higher [8]. It is evident that SCI can place a serious burden on the patient physically, psychologically, and financially.…”

Introductory Chapter: Spinal Cord Injury

“…In fact, the annual national cost in 2009 was as high as $1,7 billion [3], and for each patient ranged from $30,770 to $62,563 in 2016 [4]. The most significant cost derived from the severity of disability and complications developed during the hospitalization such as pressure ulcers and infections [5]. The SCI burden is extended also to the psychology of the younger patients, suddenly experiencing paraplegia or quadriplegia [6,7].…”