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To the Editor The use of the Nationwide Inpatient Sample (NIS) by Dr Jain and colleagues1 to estimate trends in the incidence of traumatic spinal cord injury in the United States raises several questions. Their finding of an incidence of 53 to 54 cases per 1 million inpatient hospitalizations appears only slightly lower than the cumulative incidence estimates from a study based on the Nationwide Emergency Department Sample (56.4 per 1 million), which used a more conservative approach to define acute traumatic spinal cord injury by including only persons with a principal diagnosis.2
Selvarajah S, Hammond ER, Schneider EB. Trends in Traumatic Spinal Cord Injury. JAMA. 2015;314(15):1643. doi:10.1001/jama.2015.11194
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