Epidemiology of demographic, clinical characteristics and hospital course of patients with spinal cord injury associated with vertebral fracture in a large private health care system in the United States.

Abstract

Objectives: To evaluate the demographics, clinical characteristics, hospital course, and factors associated with outcomes in patients with spinal cord injury associated with vertebral fracture (SCI-VF).Design: Retrospective analysis of data collected from electronic health record.Setting: A large for-profit United States health care system.Participants: 2219 inpatients with SCI-VF between 2014 and 2020 identified using International Classification of Disease codes.Main Outcome Measure: In-hospital mortality, and disposition (home vs. no-home discharge) after hospitalization.Results: The mean age of patients admitted with a diagnosis of SCI-VF was 54.80 ± 20.85 years with 68.27% identified as male. The cervical spine was the most prevalent site of fracture, displaced vertebral fracture was the most common radiographic diagnosis, and the majority of injuries were classified as incomplete. 836 (37.67% of all 2219) patients were discharged home and had a shorter length of stay (7.56 ± 13.58 days) when compared to the average of the total study population (11.56 ± 19.2 days). The most common hospital-acquired complication (HAC) was falls (n = 259, 11.67%). Characteristics associated with in-hospital mortality in the 96 patients (6.94% of 1,383 patients with no-home discharge) included initial respiratory failure, ICU stay, increased medical comorbidity index value, insulin use, and presence of cardiovascular, pulmonary, and gastrointestinal HACs.Conclusions: A large observational study of patients with SCI-VF can add to the knowledge of SCI characteristics in the U.S. population. Recognizing the common hospital-acquired conditions and clinical characteristics associated with increased in-hospital mortality can be helpful to improve the care of patients with SCI-VF.