Traumatic Spinal Cord Injury Mortality, 1981–1998

Purpose Our objectives were to 1) assess the long-term trend of, and 2) identify risk factors for traumatic spinal cord injury (TSCI) mortality. Methods This analysis utilized hospital discharge data and multiple cause of data from the TSCI surveillance system in South Carolina from the years 1981–1998. ICD-9 codes 806 and 952 were used to identify TSCI cases. A total of 4,353 persons sustained a TSCI, with 1,726 resulting in death. Poisson regression was used to examine trend, and multiple logistic regression was used to identify risk factors for TSCI mortality. Results The rate of TSCI mortality was 27.4 per million population between 1981–1998. A 3% annual decrease in the TSCI mortality rate was found from 1981 through 1998 (p<0.0001). Specifically, TSCI mortality rates declined the most per year in motor vehicle crashes, males, and whites. Rates in South Carolina were higher than the United States, specifically for males and blacks. Adjusted for covariates, individuals of older ages, black race, with a cervical TSCI, and with a more severe injury were associated with higher odds of in-hospital mortality. Females had lower odds of in-hospital mortality than males (OR=0.6, 95%CI: 0.4–0.9). Conclusion Although rate is decreasing, TSCI mortality, especially MVC-related, is still a significant problem, with South Carolina having higher rates of TSCI mortality than the U.S. The association between gender and in-hospital mortality needs further exploration.