Factors Associated With In-Hospital Outcomes of Traumatic Spinal Cord Injury: 10-year Analysis of the US National Inpatient Sample

Gao, Feng; Chu, Hongyu; Liang, Chen; Du, Liyong; Yang, Mingliang; Li, Jun; Yang, Degang; Zhang, Hong; Li, Jianjun; Chan, Chi Chiu

doi:10.5435/jaaos-d-18-00728

Cited by 9 publications

(4 citation statements)

References 28 publications

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“…The result of our study still cannot infer a causal relationship between operative treatment and lower mortality, because it did not record the severity of the injury and other aspects of the patient’s condition (e.g. neurological involvement) that might influence the surgeon’s decision to perform surgery 13 , 17 , 30 , 55 , 56 . The utilization of operative treatment is also associated with several challenges (e.g.…”

Section: Discussionmentioning

confidence: 88%

Traumatic spinal injury-related hospitalizations in the United States, 2016–2019: a retrospective study

Sun,

Yuan,

Zheng

et al. 2023

International Journal of Surgery

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Background: Traumatic spinal injury (TSI) is associated with significant fatality and social burden; however, the epidemiology and treatment of patients with TSI in the US remain unclear. Materials and methods: An adult population was selected from the National Inpatient Sample database from 2016 to 2019. TSI incidence was calculated and TSI-related hospitalizations were divided into operative and nonoperative groups according to the treatments received. TSIs were classified as fracture, dislocation, internal organ injury, nerve root injury, or sprain injuries based on their nature. The annual percentage change (APC) was calculated to identify trends. In-hospital deaths were utilized to evaluate the prognosis of different TSIs. Results: Overall, 95 047 adult patients were hospitalized with TSI in the US from 2016 to 2019, with an incidence rate of 48.4 per 100 000 persons in 2019 (95% CI: 46.2–50.6). The total incidence increased with an APC of 1.5% (95% CI: 0.1–3%) from 2016 to 2019. Operative TSI treatment was more common than nonoperative (32.8 vs. 3.8; 95% CI: 32.3–33.2 vs. 3.6–4%). The number of operations increased from 37 555 (95% CI: 34 674–40 436) to 40 460 (95% CI: 37 372–43 548); however, the operative rate only increased for internal organ injury (i.e. spinal cord injury [SCI])-related hospitalizations (APC, 3.6%; 95% CI: 2.8–4.4%). In-hospital mortality was highest among SCI-related hospitalizations, recorded at 3.9% (95% CI: 2.9–5%) and 28% (95% CI: 17.9–38.2%) in the operative and nonoperative groups, respectively. Conclusions: The estimated incidence of TSI in US adults increased from 2016 to 2019. The number of operations increased; however, the proportion of operations performed on TSI-related hospitalizations did not significantly change. In 2019, SCI was the highest associated mortality TSI, regardless of operative or nonoperative treatment.

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Section: Discussionmentioning

confidence: 88%

Traumatic spinal injury-related hospitalizations in the United States, 2016–2019: a retrospective study

Sun,

Yuan,

Zheng

et al. 2023

International Journal of Surgery

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“…More than 30 candidate variables were used in CART analysis, and age (≤63 or >63 years) was identified as the factor most likely to influence the likelihood of independent living. Gao et al [18] have investigated the factors associated with unfavorable in-hospital outcomes, focusing on the impact of patients' age and lesion site using the US national inpatient sample. Their multivariate analysis revealed that older age (>65 years) was significantly associated both with increased in-hospital mortality and increased adverse outcomes, regardless of the lesion site.…”

Section: Discussionmentioning

confidence: 99%

A Simplified Clinical Prediction Rule for Prognosticating Dependent Daily Living in Patients with Thoracic Spinal Cord Injury: A Multicenter Nationwide Japan Registry Study

2023

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Introduction 　　Clinical prediction rule (CPR) using decision tree analysis is able to show the branching of the variables under consideration in a clear, hierarchical manner, including specific reference values, which can be used as classifiers in clinical practice. However, CPR developed by decision tree analysis for predicting the degree of independent living of patients with thoracic spinal cord injury (SCI) are few. The purpose of this study was to develop a simplified CPR for prognosticating dependent daily living in patients with thoracic SCI. Methods 　　We extracted data on patients with thoracic SCI from a national multicenter registry database, the Japan Rehabilitation Database (JRD). All patients with thoracic SCI who were hospitalized within 30 days after injury onset were included. The independent living was categorized in the JRD as follows: independent socially, independent at home, needing care at home, independent at the facility, and needing care at the facility. These categories were used as the objective variables in classification and regression tree (CART) analysis. The CART algorithm was applied to develop the CPR for predicting whether patients with thoracic SCI achieve independent living at hospital discharge. Results 　　Three hundred ten patients with thoracic SCI were included in the CART analysis. The CART model identified, in a hierarchical order, patient’s age, residual function level, and the bathing sub-score of Functional Independence Measure as the top three factors with moderate classification accuracy and area under the curve. Conclusions 　　We developed a simplified, moderately accurate CPR for predicting whether patients with thoracic SCI achieve independent living at hospital discharge.

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“…Tout d'abord, ces résultats peuvent être expliqués par une incidence plus forte de certaines de ces pathologies aux âges plus jeunes [32][33][34][35]. Ensuite, les personnes ayant des pathologies psychiatriques ou certaines pathologies neurologiques ont des espérances de vie plus faibles qu'en population générale et des taux de mortalité plus importants [36][37][38][39][40][41].…”

Section: Discussionunclassified

Allocation aux adultes handicapés : pathologies et recours aux soins des bénéficiaires en 2017

Verboux¹,

Thomas²,

Colinot³

et al. 2022

Santé Publique

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réservés pour tous pays.La reproduction ou représentation de cet article, notamment par photocopie, n'est autorisée que dans les limites des conditions générales d'utilisation du site ou, le cas échéant, des conditions générales de la licence souscrite par votre établissement. Toute autre reproduction ou représentation, en tout ou partie, sous quelque forme et de quelque manière que ce soit, est interdite sauf accord préalable et écrit de l'éditeur, en dehors des cas prévus par la législation en vigueur en France. Il est précisé que son stockage dans une base de données est également interdit.

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Factors Associated With In-Hospital Outcomes of Traumatic Spinal Cord Injury: 10-year Analysis of the US National Inpatient Sample

Cited by 9 publications

References 28 publications

Traumatic spinal injury-related hospitalizations in the United States, 2016–2019: a retrospective study

Traumatic spinal injury-related hospitalizations in the United States, 2016–2019: a retrospective study

A Simplified Clinical Prediction Rule for Prognosticating Dependent Daily Living in Patients with Thoracic Spinal Cord Injury: A Multicenter Nationwide Japan Registry Study

Allocation aux adultes handicapés : pathologies et recours aux soins des bénéficiaires en 2017

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